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.

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.

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.

Incidental prostate cancer in patients who underwent radical cystectomy for high risk non muscle invasive bladder cancer: Is it clinically significant?

2021 ◽  
pp. 039156032110199
Author(s):  
Charalampos Fragkoulis ◽  
Ioannis Glykas ◽  
Victoria Mari ◽  
Stavros Lamprou ◽  
Lazaros Tzelves ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bladder Cancer ◽  
High Risk ◽  
Radical Cystectomy ◽  
Tumor Volume ◽  
Muscle Invasive Bladder Cancer ◽  
Incidental Prostate Cancer ◽  
Clinically Significant ◽  
Muscle Invasive ◽  
Extraprostatic Extension

Introduction and objective: Non muscle invasive, high-risk, bladder cancer is an entity which is usually treated with radical cystectomy. Incidental prostate cancer refers to prostate cancer detected in radical cystectomy specimens in patients with no signs of the disease. Objective of this study is to report the prevalence, characteristics, and clinical significance of incidental prostate cancer in non-muscle invasive bladder cancer patients treated with radical cystectomy in our department. Material and methods: We retrospectively reviewed data from 41 patients who underwent radical cystectomy for non-muscle invasive, high risk, bladder cancer during the years 2016–2020 in our department. Prostate cancer was described as clinically significant when there were positive surgical margins, extraprostatic extension, Gleason score >6, or tumor volume ⩾0.5 cm3. Two groups of patients were formed according to the presence or absence of clinically significant prostate cancer. Results: Incidental prostate cancer in the cystectomy specimens was detected in 21 of the 35 patients investigated. Clinically significant prostate cancer was detected in five patients. Positive surgical margins and extraprostatic extension were present in one patient, respectively. Gleason score was more than six in four of the five patients and PCa tumor volume was above 0.5 cm3 in three patients. Two patients with clinically significant prostate cancer were diagnosed with biochemical recurrence during their follow up. Conclusions: In non-muscle invasive, high-risk patients undergoing radical cystectomy, clinically significant incidental PCa is an important issue as it may affect prognosis, quality of life, metastasis free survival, and overall survival.

Incidental prostate cancer in patients with radical cystectomy for bladder cancer.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 225-225
Author(s):  
Hooman Djaladat ◽  
Max H. Bruins ◽  
Eila C. Skinner ◽  
Gus Miranda ◽  
Jie Cai ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Transitional Cell ◽  
Prostate Adenocarcinoma ◽  
Adjuvant Radiation ◽  
Incidental Prostate Cancer ◽  
Hormone Ablation ◽  
Multifocal Disease

225 Background: Radical cystectomy is the gold standard surgical treatment for invasive bladder cancer. Prostate adenocarcinoma is often found incidentally in the cystoprostatectomy specimen. The clinical significance of this type of cancer has not been well characterized. We reviewed the cohort of male patients with bladder cancer who underwent radical cystectomy and found to have incidental prostate adenocarcinoma. Methods: 1,964 patients with primary transitional cell carcinoma of bladder underwent radical cystectomy between 1971 and 2008 with a median follow-up of 12.1 yrs (0.1-36) at USC. 1553 of them were male (79%) and 559 (36%) had incidental pathologic prostate adenocarcinoma (PC-group). Prostate and bladder cancer characteristics, recurrence and overall survival (OS) in the cohort of PC-group are reviewed. Results: Median age in the PC-group was 69 yo (35-92). The incidental PC was organ confined (OC) in 527 patients (94%). 32 (6%) had non-OC prostate cancer, treated by adjuvant radiation (5), hormone ablation (3) with a median follow-up of 3.9 yrs (0.1-16). Median pre-op PSA was 1.66 (0.01-83) in PC-group and 1.31 (0.01-33.2) in non-PC group. Gleason score was ≤ 6 in 458 (82%), 7 in 78 (14%) and ≥ 8 in 12 (2%) cases. Reviewing bladder cancer in the PC vs. non-PC group, 84 and 83% had high-grade cancer, 63 and 58% had associated CIS, 41 and 36% had multifocal disease and 29 and 27% had LVI respectively (P > 0.05). Incidental PC did not have significant effect on recurrence (P=0.3) and OS (P=0.4) after cystectomy for bladder urothelial cancer. No patient died of PC. 5-year OS rate was 60 ± 2% in both PC and non-PC groups. 10-year OS rate was also comparable at 42 ± 2% in PC and 44 ± 2% in non-PC-group. Conclusions: Incidental prostate adenocarcinoma is reported in more than one third of patients who undergo radical cystectomy for bladder cancer. It is organ confined in most of the cases and has no correlation with bladder cancer stage. Outcome of patients with incidental prostate adenocarcinoma at the time of radical cystectomy relies exclusively on the bladder cancer.

Risk factors for significant prostate cancer in radical cystoprostatectomy specimen: A retrospective analysis.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 136-136
Author(s):  
Andrea Katharina Thissen ◽  
Daniel Porres ◽  
David J. K. P. Pfister ◽  
Axel Heidenreich
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Bladder Cancer ◽  
Retrospective Analysis ◽  
Potential Risk ◽  
Common Finding ◽  
Considerable Proportion ◽  
Radical Cystoprostatectomy ◽  
Potential Risk Factors

136 Background: Prostate cancer (Pca) has been found incidentally in radical cystoprostatectomy (RCP) specimens in 27-70%. We evaluated histopathological features and clinical outcome of patients with incidental Pca undergoing RCP for urothelial bladder cancer and identified potential risk factors for the presence of significant Pca, being defined as Gleason Score ≥7b, primary tumor ≥T2c or Pca volume ≥0.5cm3. Methods: A retrospective analysis of patients who underwent RCP between 01/2005-03/2015 was performed with regard to clinical data and pathohistological features. Whole mount serial sections of specimens were examined in the same urological and pathological institution. Pca grade, p-stage, cancer volume and surgical margins were recorded. Preoperative PSA values and follow-up were analysed. Results: We identified 71 patients with incidental Pca with a mean age of 71.7 years (47-84 years). 33/71 patients (46.5%) had significant Pca (28.2% ≥T2c, 4.2% GS ≥7b [+≥T2c], 14.1% cancer volume ≥0.5cm3[+≥T2c]). Other features were as follows: pT2a, n=36 (50.7%); pT2b, n=2 (2.8%); GS 6, n=50 (70.4%); GS 7a, n=18 (25,3%). All patients were R0 and N0 for Pca. Mean preoperative PSA level was 2.7ng/ml. None of the patients developed biochemical recurrence (median follow-up: 29.5 [1-124 months]). Patients with significant Pca were older than those with insignificant Pca (median age 71.2 years vs 70.1 years) and had higher preoperative PSA levels: 90% of patients with a PSA level of 4-10ng/ml had a ≥T2c Pca, while 81.5% of patients with PSA levels of 0-1ng/ml had a pT2a Pca. P-stages in patients with PSA values between 1-4ng/ml were found to be equally distributed between pT2a-pT2c. Conclusions: The occurence of incidental Pca is a common finding in patients undergoing RCP, with a considerable proportion having the characteristics of significant Pca. Potential risk factors for significant Pca are older age and PSA levels >4ng/ml. However, none of the patients experienced biochemical relapse or Pca-related death during the follow-up. In line with published data, incidental Pca does not impact on the oncological outcome of patients undergoing RCP. The prognosis is primarily determined by bladder cancer.

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

scholarly journals The incidence of prostate cancer and urothelial cancer in the prostate in cystoprostatectomy specimens in a tertiary care Canadian centre

2013 ◽  
Vol 7 (1-2) ◽  
pp. 35 ◽  
Author(s):  
Sri Sivalingam ◽  
Darrel Drachenberg
Keyword(s):  
Prostate Cancer ◽  
Bladder Cancer ◽  
Urothelial Cancer ◽  
Tertiary Care ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Radical Cystoprostatectomy ◽  
Functional Benefit ◽  
Clinically Significant ◽  
Muscle Invasive

Introduction: Radical cystoprostatectomy remains the gold standard treatment for muscle invasive bladder cancer. However, given the treatment related complications of compromised potency and continence with this procedure, prostate/sexuality sparing cystectomyin orthotopic neobladder candidates has emerged in an effort to minimize these quality of life concerns. Recent evidence suggests only a marginal functional benefit from these technical refinements. We sought to determine the incidence of occult prostate cancer and urothelial cancer of the prostate in cystoprostatectomy specimens conducted for muscle invasive bladder cancer.Methods: We retrospectively reviewed 83 male patients who underwent radical cystoprostatectomy for muscle invasive bladder cancer between April 2004 and March 2007. The median age ofour study group was 71 years. Pathologic findings of prostate/urothelia lcancer in the prostate were identified. Clinically significant prostate cancer was defined as Gleason score >6, tumour volume >0.5cc, extracapsular extension or perineural invasion.Results: Our review yielded a 30% (±10%, 0.95 CI) rate of prostate cancer, with 19% (± 8.5%, 0.95 CI) of total specimens being positive for clinically significant prostate cancer. Urothelial cancer in the prostate was identified in 16% (±8.5%, 0.95 CI) of patients, with an overlap with prostate cancer in 2 patients. The overall rate of an underlying cancer within the prostate of our cystoprostatectomy specimens was about 46% (±10.7%, 0.95 CI).Conclusion: These findings suggest that the oncological risk of leaving behind residual cancer may not justify the practice of prostate sparing cystectomies.

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