Incidental Prostatic Adenocarcinoma
in Patients Undergoing Radical
Cystoprostatectomy for Bladder
Cancer

Abbas, Farhat; Hochberg, David A.; Civantos, Francisco; Soloway, Mark S.

doi:10.1159/000474190

Cited by 89 publications

(74 citation statements)

References 11 publications

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“…Prophylactic radical prostatectomy or radiation is not an acceptable treatment for patients who have high-grade PIN only. 174 The development and identification of acceptable agents to treat high-grade PIN would fill a therapeutic void. As noted above, androgen deprivation therapy and radiation therapy induce acinar atrophy and apoptosis that result in regression of high-grade PIN.…”

Section: Should Men With High-grade Pin Be Treated?mentioning

confidence: 99%

“…As noted above, androgen deprivation therapy and radiation therapy induce acinar atrophy and apoptosis that result in regression of high-grade PIN. 70,[161][162][163]169,[174][175][176] Chronic therapy, however, would most likely be required to prevent new high-grade PIN lesions from invading and becoming clinical prostate cancer. Although more toxicity is likely to be tolerated for the treatment agents targeted to regress or inhibit high-grade PIN, as compared to treating healthy patients to reduce prostate cancer incidence, androgen deprivation therapy has too many adverse effects in men to be clinically useful.…”

Section: Should Men With High-grade Pin Be Treated?mentioning

confidence: 99%

“…Newer agents with better safety and lower side effect profile are greatly needed since patients may be taking the agent at least until they attain 70 years of age. 174 Acapodene, an antiestrogen is currently in a Phase IIb multicenter, randomized, prospective placebocontrolled human clinical trial to determine if it can treat high-grade PIN and reduce prostate cancer incidence; preliminary results are encouraging. 30 PIN offers promise as an intermediate end point in studies of chemoprevention of prostatic carcinoma.…”

Section: Should Men With High-grade Pin Be Treated?mentioning

confidence: 99%

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High-grade prostatic intraepithelial neoplasia

2004

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High-grade prostatic intraepithelial neoplasia (PIN) is now accepted as the most likely preinvasive stage of adenocarcinoma, almost two decades after its first formal description. PIN has a high predictive value as a marker for adenocarcinoma, and its identification warrants repeat biopsy for concurrent or subsequent invasive carcinoma. The only method of detection is biopsy; PIN does not significantly elevate serum prostate-specific antigen (PSA) concentration or its derivatives and cannot be detected by current imaging techniques, including ultrasound. Most patients with PIN will develop carcinoma within 10 years. PIN is associated with progressive abnormalities of phenotype and genotype, which are similar to cancer rather than normal prostatic epithelium, indicating impairment of cell differentiation with advancing stages of prostatic carcinogenesis. Androgen deprivation therapy decreases the prevalence and extent of PIN, suggesting that this form of treatment may play a role in chemoprevention.

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Section: Should Men With High-grade Pin Be Treated?mentioning

confidence: 99%

Section: Should Men With High-grade Pin Be Treated?mentioning

confidence: 99%

Section: Should Men With High-grade Pin Be Treated?mentioning

confidence: 99%

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High-grade prostatic intraepithelial neoplasia

2004

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“…[31] Mesanenin ürotelyal kanseri ile prostat adenokanserinin birlikte görülme sıklığı normal PSA değerleri ve parmakla rektal muayene bulguları olan hasta grupları ile yapılan çalışmalarda bile %27 ile %70 arasında değişmektedir. [17,[32][33][34] Bu oran otopsi çalışma-larında saptanan rastlantısal prostat kanseri oranların-dan çok daha yüksektir. Bu oranların bu kadar yüksek saptanmasının altında özellikle RSP yapılan hastaların klinik olarak detaylı değerlendirilmesi ve kapsamlı bir histopatolojik değerlendirme yatmakla birlikte bu derecede yüksek oranlar prostat koruyuculu bir radikal sistektomi konusunda ciddi şüphelerin oluşmasına neden olmaktadır.…”

Section: çAlışma N Prostat Kanseri N %unclassified

The Frequency of Incidentally Detected Prostate Cancer in Patients Undergoing Radical Cystoprostatectomy for Urotelial Bladder Carcinoma

Selimoglu¹,

Türk²,

Hamarat³

et al. 2014

J Kartal TR

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ÖzetAmaç: Bu çalışmada mesane ürotelyal kanseri nedeniyle radikal sistoprostatektomi yapılan hastalarda prostat adenokarsinom sıklığını araştırmayı ve prostat kanseri saptanan olguların histopatolojik özelliklerini ortaya koymayı amaçladık. Gereç ve Yöntem:Ocak 2005 ile Haziran 2011 yılları arasında mesane ürotelyal kanseri nedeniyle radikal sistoprostatektomi yapılan ve ameliyat öncesi prostat kanseri tanısı olmayan 157 erkek hasta çalışmaya alındı. Hastaların patolojileri geriye dö-nük olarak değerlendirildi. Üriner diversiyon olarak 125 hastaya ileal konduit, 28 hastaya ortotopik ileal mesane ve dört hastaya üreterokütanostomi tekniği uygulandı. Bulgular: Radikal sistoprostatektomi uygulanan 157 hastanın 26'sında (%16.5) prostat kanseri saptandı. Prostat kanseri saptanan hastaları ortalama yaşı 67.3 yıl, saptanmayanların ise 61 yıl idi. Ortalama PSA değerleri prostat kanseri saptanan ve saptanmayan hastalarda sırası ile 2.9±0.35 ng/dl ve 2.7±0.41 ng/dl idi. Prostat kanseri saptanan hastaların Gleason skoru bir hastada 2+2, bir hastada 4+3 ve 24 hastada 3+3 olarak bulundu. Bu hastaların mesane kanseri patolojik evresi ise 10 hastada T4N2, bir hastada T4N1, dört hastada T3N1, sekiz hastada T2N0, bir hastada T1N0 ve iki hastada T0N0 olarak bulundu.Sonuç: Çalışmamızda radikal sistoprostatektomi uygulanan hastalarda rastlantısal prostat kanseri saptanma sıklığı %16.5 olarak bulunmuş olup bu nedenle hastaların patolojilerinin dikkatli ve detaylı değerlendirilmesi gerektiğini düşünmekteyiz.Anahtar sözcükler: Rastlantısal prostat adenokarsinomu; sistoprostatektomi; ürotelyal mesane karsinomu. SummaryBackground: The aim of this study is to evaluate the incidence of prostate adenocarcinoma in patients who underwent radical cystoprostatectomy for urotelial carcinoma, and present the histopathological features of these patients.

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“…It is suggested that the incidental prostate cancer frequency in the pathology specimens of patients who have undergone radical cystoprostatectomy (RCP) is between 17% and 70%, and the apex of the prostate is the involvement location of cancer at a rate of 41-75%. It was detected that the invasion frequency of cancer in the bladder to the prostate tissue was 5-43% (2). While some surgeons prefer protecting the prostate or prostate capsule apex and taking the risk of leaving cancer tissue for the purpose of decreasing unwanted urinary and sexual side effects, others recommend removal of all the prostate tissue, including the apex, arguing that the frequency of incidental prostate adenocarcinoma is higher than expected in patients who have undergone RCP due to bladder cancer (3).…”

Section: Introductionmentioning

confidence: 99%

Incidental Prostate Cancer Frequency and Features of Patients Undergoing Radical Cystoprostatectomy

Balci¹,

Onuk²,

Hazar³

et al. 2016

JAREM

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Objective: Prostate cancer (PC) is one of the major health problems among males. Pathology specimens of patients with incidental PC who underwent radical cystoprostatectomy (RCP) have been reported to be 17-70% in different series. In this study, we aimed to determine the frequencies and features of incidental PC in patients who underwent RCP.Methods: In our study, 142 patients who underwent RCP were retrospectively evaluated between 1999 and 2015. Women and patients diagnosed with PC before were excluded. Preoperative PSA levels were 2.05-9.31 ng/mL. Standard RSP and standard pelvic lymphadenectomy were performed.Results: Incidental PC was detected in 22 of 142 patients. The frequency of incidental PC was found to be 15.4% in RSP materials. In 10 of 22 patients with PC, high-grade prostatic intraepithelial neoplasia (PIN) areas were detected. Further, 14 of 120 patients without PC had highgrade PIN zones. In 140 patients, transitional cell carcinoma was detected, and the other 2 patients had signet ring cell carcinoma. In bladder specimens, 68 patients were in the T2 stage, while 58 patients and 16 patients were in the T3 and T4 stages, respectively. The Gleason score (GS) was 2+3=5 in 2 of the 22 incidental PC patients. Moreover, 6 patients had GS of 3+2=5 and 14 patients had GS of 3+3=6. Conclusion:Most incidentally detected PCs in RCP specimens are small, localized, and well-differentiated tumors. Extracapsular extension was not observed in any of them. Patients with invasive bladder tumors and PCs together have a lower T stage than those with only invasive bladder tumors. The risk of PC is higher in patients with invasive bladder cancer than in the healthy population. Preoperative prostate evaluation, prostate dissection, and resection should be performed with oncologic surgery. (JAREM 2016; 6: 15-8)

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Incidental Prostatic Adenocarcinoma in Patients Undergoing Radical Cystoprostatectomy for Bladder Cancer

Cited by 89 publications

References 11 publications

High-grade prostatic intraepithelial neoplasia

High-grade prostatic intraepithelial neoplasia

The Frequency of Incidentally Detected Prostate Cancer in Patients Undergoing Radical Cystoprostatectomy for Urotelial Bladder Carcinoma

Incidental Prostate Cancer Frequency and Features of Patients Undergoing Radical Cystoprostatectomy

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