Incidental Prostate Cancer in Radical Cystoprostatectomy Specimens is Associated with Worse Overall Survival

2021 ◽  
pp. 1-7
Author(s):  
Takahiro Kimura ◽  
Hajime Onuma ◽  
Shun Sato ◽  
Hiroyuki Inaba ◽  
Wataru Fukuokaya ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Bladder Cancer ◽  
Statistical Significance ◽  
Pathological Features ◽  
Incidental Prostate Cancer ◽  
P Values ◽  
Radical Cystoprostatectomy ◽  
Oncological Outcomes ◽  
The Impact

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.

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

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
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.

Systematic review of time to definitive treatment for intermediate-risk and high-risk prostate cancer: Are delays associated with worse outcomes?

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 233-233
Author(s):  
David-Dan Nguyen ◽  
Lorine Haeuser ◽  
Marco Paciotti ◽  
Chanan Reitblat ◽  
Jacqueline Cellini ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Overall Survival ◽  
High Risk ◽  
Definitive Treatment ◽  
Intermediate Risk ◽  
Pathological Features ◽  
Pathological Findings ◽  
Treatment Delays ◽  
Oncological Outcomes

233 Background: Prostate cancer (PCa) is an indolent disease, especially when detected at a localized stage. Unlike other tumors that may benefit from timely receipt of definitive therapy, it is generally accepted that treatment delays for localized PCa are acceptable, especially for low-risk PCa. We sought to determine if treatment delays for intermediate-risk and high-risk PCa negatively impacted oncological outcomes. Methods: We conducted a systematic review of the literature with searches of Medline, EMBASE, and the Cochrane Database of Systematic Reviews, from inception to June 30, 2020. General study characteristics as well as study population and delay information were collected. The outcomes of interest extracted included biochemical recurrence (BCR), pathological features (positive surgical margins, upgrading, extracapsular extension, and other pathological features), cancer-specific survival, and overall survival. Due to significant heterogeneity between studies, a meta-analysis was not possible. Results: After identifying 1793 unique references, 24 manuscripts met criteria for data extraction, 15 of which were published after 2013. Based on our review, delays up to 3 months are safe for all PCa and are not associated with worse oncological outcomes. Some studies identified worse oncological outcomes as a result of delays beyond 6 to 9 months. However, these studies are counterbalanced by others finding no statistically significant association with delays up to 12 months. Studies that did find worse outcomes as a result of delays identified a higher risk of BCR and pathological findings, but not worse survival. Conclusions: Definitive treatment for intermediate-risk and high-risk PCa can be delayed up to 3 months without any oncological consequences. Some evidence suggests that delays beyond 6-9 months are associated with a higher risk of BCR and varying worse pathological findings; as such, care should be given to provide definitive treatment within 9 months. To date, there is no evidence of worse cancer-specific or overall survival as a result of delayed treatment for intermediate-risk and high-risk PCa.

scholarly journals The Impact of Metformin Use with Survival Outcomes in Urologic Cancers: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Xiangyang Yao ◽  
Haoran Liu ◽  
Hua Xu
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Bladder Cancer ◽  
Cancer Patients ◽  
Kidney Cancer ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Effect Model ◽  
Urologic Cancers ◽  
The Impact

Background. Conflicting results exist between the potential protective effects of metformin and the prognosis of urologic cancers. This meta-analysis summarized the effects of metformin exposure on the recurrence, progression, cancer-specific survival (CSS), and overall survival (OS) of the three main urologic cancers (kidney cancer, bladder cancer, and prostate cancer). Methods. We systematically searched PubMed, Embase, Web of Science, Wanfang, and China National Knowledge Infrastructure databases (January 2010 to December 2019), which identified studies regarding metformin users and nonusers with urologic cancers and extracted patient data. A random effect model or fixed effect model was used to analyze hazard ratios (HRs) and 95% confidence intervals (CIs). Results. Among the 1883 confirmed studies, 27 eligible studies were identified, including 123,212 participants. In prostate cancer, patients using metformin have significant benefits for recurrence ( HR = 0.74 ; 95% CI: 0.61-0.90; P = 0.007 ; I 2 = 56 % ), CSS ( HR = 0.74 ; 95% CI: 0.61-0.91; P = 0.002 ; I 2 = 79 % ), and OS ( HR = 0.76 ; 95% CI: 0.65-0.90; P < 0.001 ; I 2 = 86 % ). Moreover, further subgroup analysis showed that the beneficial effects of metformin may be more significant for patients receiving radical radiotherapy. For kidney cancer, metformin was beneficial for progression ( HR = 0.80 ; 95% CI: 0.65-0.98; P = 0.14 ; I 2 = 46 % ). Analysis revealed that the effect of metformin on the overall survival of kidney cancer patients may be related to nationality (American: HR = 0.76 ; 95% CI: 0.59-0.98; P = 0.88 ; I 2 = 0 % ). For bladder cancer, no obvious benefits of metformin use were identified. However, subgroup analysis indicated that metformin may improve the recurrence of bladder cancer, but this improvement was only found in patients with a median follow-up time of more than 4 years ( HR = 0.43 ; 95% CI: 0.28-0.67; P = 0.61 ; I 2 = 0 % ).

scholarly journals Incidental prostate cancer diagnosed at radical cystoprostatectomy for bladder cancer: disease-specific outcomes and survival

2016 ◽  
Vol 4 (3) ◽  
pp. 107-112 ◽  
Author(s):  
Joshua B. Kaelberer ◽  
Michael A. O'Donnell ◽  
Darrion L. Mitchell ◽  
Anthony N. Snow ◽  
Sarah L. Mott ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bladder Cancer ◽  
Cancer Disease ◽  
Incidental Prostate Cancer ◽  
Radical Cystoprostatectomy ◽  
Disease Specific

648 Incidence and prognosis of clinically significant incidental prostate cancer in radical cystoprostatectomy for bladder cancer

2015 ◽  
Vol 14 (2) ◽  
pp. e648
Author(s):  
I.M. Jiménez-Valladolid ◽  
E. De La Peña ◽  
V. Hernández ◽  
A. Guijarro ◽  
E. Pérez-Fernández ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bladder Cancer ◽  
Incidental Prostate Cancer ◽  
Radical Cystoprostatectomy ◽  
Clinically Significant

scholarly journals Relevance of prostate cancer in patients with synchronous invasive bladder urothelial carcinoma: a monocentric retrospective analysis

2015 ◽  
Vol 87 (1) ◽  
pp. 76 ◽  
Author(s):  
Lucio Dell’Atti
Keyword(s):  
Prostate Cancer ◽  
Bladder Cancer ◽  
Urothelial Carcinoma ◽  
Statistical Significance ◽  
Surgical Margin ◽  
Positive Surgical Margin ◽  
Cancer Specific Survival ◽  
Incidental Prostate Cancer ◽  
Clinically Significant

Objectives: We retrospectively reviewed data of patients with incidental prostate cancer (PCa) who underwent radical cystoprostatectomy (RCP) for invasive bladder cancer and we analyzed their features with regard to incidence, pathologic characteristics, clinical significance, and implications for management. Material and Methods: Clinical data and pathological features of 64 patients who underwent standard RCP for bladder cancer were included in this study. Besides the urothelial carcinoma of the urinary bladder, the location and tumor volume of the PCa, prostate apex involvement, Gleason score, pathological staging and surgical margins were evaluated. Clinically significant PCa was defined as a tumor with a Gleason 4 or 5 pattern, stage ≥ pT3, lymph node involvement, positive surgical margin or multifocality of three or more lesions. Postoperative follow-up was scheduled every 3 months in the first year, every 6 months in the second and third year, annually thereafter. Results: 11 out of 64 patients (17.2%) who underwent RCP had incidentally diagnosed PCa. 3 cases (27.3%) were diagnosed as significant PCa, while 8 cases (72.7%) were clinically insignificant. The positive surgical margin of PCa was detected in 1 patient with significant disease. The prostate apex involvement was present in 1 patient of the significant PCa group. Median follow-up period was 47.8 ± 29.2 (range 4-79). During the follow-up, biochemical recurrence occurred in 1 patient (9%). Concernig the cancer specific survival there was no statistical significance (P = 0.326) between the clinically significant and clinical insignificant cancer group. Conclusions: In line with published studies, incidental PCa does not impact on the prognosis of bladder cancer of patients undergoing RCP.

scholarly journals Incidental Prostate Cancer in Patients Undergoing Radical Cystoprostatectomy for Bladder Cancer

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.

scholarly journals Incidental prostate cancer in patients with muscle-invasive bladder cancer who underwent radical cystoprostatectomy

2017 ◽  
Vol 47 (11) ◽  
pp. 1078-1082 ◽  
Author(s):  
Toshikazu Tanaka ◽  
Takuya Koie ◽  
Chikara Ohyama ◽  
Yasuhiro Hashimoto ◽  
Atsushi Imai ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bladder Cancer ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Incidental Prostate Cancer ◽  
Radical Cystoprostatectomy ◽  
Muscle Invasive
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