Is there a PSA cut-off value indicating incidental prostate cancer in patients undergoing surgery for benign prostatic hyperplasia?

  • Senol Tonyali | Department of Urology, Istanbul University Istanbul School of Medicine, Istanbul, Turkey.
  • Cavit Ceylan Department of Urology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
  • Erdogan Aglamis Department of Urology, University of Health Sciences, Elazig City Hospital, Elazig, Turkey.
  • Serkan Dogan Department of Urology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey.
  • Sedat Tastemur Department of Urology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
  • Mustafa Karaaslan Department of Urology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.


Aim: To investigate incidental prostate cancer (IPCa) rate and to determine prostate specific antigen (PSA) cut-off value indicating PCa in patients who underwent surgery by being diagnosed with benign prostatic hyperplasia (BPH) clinically or by standard prostate biopsy.
Methods: Data of 317 patients, who underwent transurethral resection of the prostate (TURP) or open prostatectomy (OP) with pre-diagnosis of BPH, were evaluated retrospectively. The examined parameters included patients’ demographics, preoperative serum PSA values, digital rectal examination (DRE) findings, surgical method, histopathological findings and Gleason Scores.
Results: A total of 317 patients were included the study. The median age of patients was 69 years (min: 51-max: 79) and the median PSA value was 3.24 ng/dl (min: 0.17-max: 34.9). In 21 patients (6.6%); DRE findings were in favor of malignancy, but prostate biopsy resulted as BPH. While 281 (88.6%) of the patients underwent TURP, 36 (11.4%) underwent open prostatectomy. PCa was detected in 21 (6.6%) patients. PSA was statistically higher in patients who underwent OP compared to patient who underwent TUR-P, 5.9 (min: 1.2 - max: 27.6, IR: 8.7) vs. 2.8 (min: 0.1-max: 34.9, IR: 4.2) ng/dl, p < .001. The rate of IPCa among four PSA group was similar (p = 0.46). There was no difference between the rate of IPCa in patients younger and older than 70 years, (p = 0.11). Please change whole sentence as 'The median PSA level was slightly higher in patients diagnosed with BPH compared to patients diagnosed with IPCa, 3.2 (min: 0.1-max: 34.9) vs. 2.7 (min: 0.3-max: 26.5) ng/dL, p = 0.9.
Conclusions: IPCa still remains an important clinical problem. We were not able to find any correlation of PSA and age with incidental PCa.



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Original Papers - Prostate
incidental, prostate cancer, open prostatectomy
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How to Cite
Tonyali, S., Ceylan, C., Aglamis, E., Dogan, S., Tastemur, S., & Karaaslan, M. (2021). Is there a PSA cut-off value indicating incidental prostate cancer in patients undergoing surgery for benign prostatic hyperplasia?. Archivio Italiano Di Urologia E Andrologia, 93(1), 31-34.