Incidental prostate cancer in Asian men: High prevalence of incidental prostatic adenocarcinoma in Chinese patients undergoing radical cystoprostatectomy for treatment of bladder cancer and selection of candidates for prostate-sparing cystectomy

BACKGROUND: The impact of incidental prostate cancer (IPC) on oncological outcomes after radical cystoprostatectomy (RCP) specimens from patients with bladder cancer (BC) remains controversial. This relationship has not been well elucidated in Asian countries, where the incidence of prostate cancer has recently shown dramatic increases. OBJECTIVES: This study retrospectively compared pathological features and oncological outcomes between BC patients with and without IPC in the RCP specimens. METHODS: This study included 142 men who underwent RCP for BC. Men who were previously diagnosed with prostate cancer were excluded. Each prostate gland and seminal vesicle was processed as whole mounts and 4-mm close-step sectioning was performed. A single genitourinary pathologist diagnosed IPC. The pathological features and oncological outcomes such as overall survival (OS), bladder cancer-specific survival (BCSS), and progression-free survival (PFS) were compared between patients with IPC (IPC+group, n = 45) and without IPC (IPC- group, n = 97). P values less than 0.05 considered to indicate statistical significance for patients’ characteristics. Because of multi-primary endpoint, P values less than 0.0167 was considered statistical significance for oncological outcomes. RESULTS: We detected IPC in 45 RCP specimens (31.6%). Patients in the IPC- group were significantly younger at surgery than those in the IPC+group (P < 0.001). The pathological features of the RCP specimens did not differ significantly. In multivariable analyses, presence of IPC was significantly associated with worse OS (P = 0.005), but not with either BCSS or PFS (P = 0.038 and 0.326, respectively). In Kaplan–Meier analyses, OS tended to be longer in the IPC- group than that in the IPC+group (NR vs 65 months, P = 0.0017). CONCLUSIONS: Our results suggested significantly better OS in patients without IPC than that in those with IPC.

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Incidental Prostate Cancer in Patients Undergoing Radical Cystoprostatectomy for Bladder Cancer

Bosnian Journal of Basic Medical Sciences ◽

10.17305/bjbms.2008.2970 ◽

2008 ◽

Vol 8 (2) ◽

pp. 147-151

Author(s):

Mustafa Hiroš ◽

Hajrudin Spahović ◽

Mirsad Selimović ◽

Sabina Sadović

Keyword(s):

Prostate Cancer ◽

Bladder Cancer ◽

Specific Antigen ◽

Digital Rectal Examination ◽

Complete Removal ◽

Incidental Prostate Cancer ◽

Radical Cystoprostatectomy ◽

Age Limits ◽

Work Up ◽

Urology Clinic

The objective of this work is to verify the incidence of incidental prostate adenocarcinoma in patients who underwent radical cystoprostatectomy for invasive bladder carcinoma. We have retrospectively reviewed patients who underwent radical cystoprostatectomy for infiltrative bladder tumors in period between 2003 and 2007 year, 94 men with bladder cancer underwent radical cystoprostatectomy at Urology Clinic-University of Sarajevo Clinics Centre. Mean age of patients was 67 years, with age limits ranging between 48 and 79 years. Pathohystological evaluation was used for all specimens from RCP. We found that 9,57% of cystoprostatectomy specimens in patients with bladder cancer also contained incidental prostate cancer. This result was much lower than overall mean frequency of incidentally detected prostate cancer in other series of cystoprostatectomy cases (range, 23%-68%). In conclusion we recommended digital rectal examination (DRE) and prostate-specific antigen (PSA) test as part of the bladder cancer work up and complete removal of the prostate at cystoprostatectomy to prevent residual prostate cancer.

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Incidentally Found Prostate Cancer and Influence on Overall Survival after Radical Cystoprostatectomy

Prostate Cancer ◽

10.1155/2012/690210 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 8

Author(s):

Algimantas Sruogis ◽

Albertas Ulys ◽

Giedre Smailyte ◽

Zygimantas Kardelis ◽

Arunas Kulboka ◽

...

Keyword(s):

Prostate Cancer ◽

Overall Survival ◽

Bladder Cancer ◽

Incidental Prostate Cancer ◽

Vital Status ◽

Radical Cystoprostatectomy ◽

Clinically Significant ◽

Using Data ◽

Extraprostatic Extension

Objectives. To determine incidentally found prostate cancer frequency and impact on overall survival after RCP.Patients and Methods. The records of 81 men who underwent cystoprostatectomy from January 2000 to December 2009 were reviewed. The vital status of the study group was assessed as on September 1, 2009, by passive followup, using data from the population registry.Results. The 81 men underwent RCP. The incidental prostate cancer was found in the specimens of 27 (33.3%) patients. 13 (48.1%) of 27 prostate cancer cases were clinically significant. For 3 patients (11.1%) an extraprostatic extension was found. For 2 patients (7.4%)—positive margins, for 1 patient (3.7%)—Gleason sum 8, and for the rest 7 patients bigger than 0.5 cm3volume tumor, and Gleason sum 7 was found. The mean follow-up time was months (varies from 0.8 to 131.2 months). The patients with bladder cancer and incidentally found prostate cancer lived shorter ( and months). Higher overall survival () was found in the patient group with bladder cancer without incidentally diagnosed prostate cancer.Conclusion. There are indications that in this small study prostate cancer has influenced on patients' survival with bladder cancer after radical cystoprostatectomy.

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