Prognostic Significance of Incidental Prostate Cancer at Radical Cystoprostatectomy for Bladder Cancer

Abstract

Objective: The aim of the study was to evaluate the impact of the clinical significance of incidental prostate cancer (PC) on overall survival (OS) after radical cystoprostatectomy (RC) for bladder cancer (BC). Methods: A total of 822 consecutive men underwent RC in 3 academic centers between 1996 and 2011. The clinical significance of incidental PC was determined according to the Epstein criteria. The Kaplan-Meier analysis with log-rank was used to investigate the impact of PC on OS and univariate and multivariate Cox regression analyses for risk factors of OS. The median follow-up was 36 months (interquartile range 10-49). Results: Of the 822 men, 117 (14.2%) had clinically significant, 243 (29.6%) insignificant and 462 (56.2) no PC at RC. Men with PC were at higher risk for lymphovascular invasion (LVI) of BC compared to men without PC (p < 0.001). The 5-year OS for men with clinically significant, insignificant and no PC was 33.3, 51.3 and 51.5%, respectively (p = 0.050). In the subgroup of pN0 patients (n = 601), clinically significant PC was significantly associated with inferior OS (p = 0.044) but not in multivariable analysis (p = 0.46). Conclusions: We did not find the clinical significance of incidental PC to be an independent predictor. However, the positive correlation between incidental PC and LVI of BC deserves further investigation.

Oncological and functional outcome of robotic‐assisted radical cystectomy with total intracorporeal stentless J‐pouch neobladder reconstruction

“…The prevalence of incidental prostate cancer during this procedure has been reported to range from 6.8% to 43.7% in previous studies. Additionally, the rate of incidental insignificant prostate cancer has been found to be higher than that of significant prostate cancer 44,45 . However, the long‐term outcome of incidental prostate cancer is generally favourable, with a 10‐year prostate‐cancer‐specific survival rate of 99% 46 .…”

“…Additionally, the rate of incidental insignificant prostate cancer has been found to be higher than that of significant prostate cancer. 44,45 However, the long-term outcome of incidental prostate cancer is generally favourable, with a 10-year prostate-cancer-specific survival rate of 99%. 46 Only a small proportion of patients developed subsequent biochemical recurrences, most of whom were able to achieve long-term survival with androgen-deprivation therapy.…”

Radikal Sistoprostatektomi Materyalinde İnsidental Prostat Kanseri Saptanan Olguların Klinikopatolojik Özellikleri

“…Çalışmamızda, Epstein ve ark.ları tarafından önerilen kriterlere dayanarak 35 (%24,8) hastada klinik olarak önemli PK tespit edildi. Benzer kriterleri kullanan Gakis ve ark.larının çalışmasında klinik olarak önemli PK oranı %14 olarak saptanırken, Nakagawa ve ark.ları yüksek oranda (%74,7) klinik olarak önemli PK tespit etmişlerdir 21,22 . Serum PSA değeri genellikle hastanın PK gelişme riski ile bağlantılıdır ancak, düşük PSA değeri PK varlığını dışlamaz 23 .…”