Prostatic Involvement by Transitional Cell Carcinoma: Pathogenesis, Patterns and Prognosis

Abstract

Prostatic involvement by transitional cell carcinoma of the bladder includes a spectrum of histologic patterns. Ductal only or ductal and acinar involvement occurs with or without stromal invasion. Stromal invasion may exist without glandular involvement. Invasive prostatic patterns are most frequent in the setting of high stage invasive bladder tumors and 5-year survival rates for these patients are low. Non-invasive in situ prostatic patterns are usually associated with low stage bladder tumors and 5-year survival approaches that predicted from radical cystectomy for low stage bladder tumor alone. When an invasive pattern is associated with a low stage bladder tumor the 5-year survival rate is determined by the prostatic lesion and is low. Although the survival rate is severely jeopardized by stromal prostatic invasion the prognosis is not hopeless. Preoperative radiotherapy followed by cystoprostatourethrectomy can be expected to produce a 20 per cent 5-year survival rate.

Incidental Prostate Cancer: The Importance of Complete Prostatic Removal at Cystoprostatectomy for Bladder Cancer

“…Preservation of apical prostatic tissue to improve urinary continence postoperatively is not advisable if a significant number of bladder cancer patients are expected to have concurrent prostate cancer. Since apex is the most common site, with mapping studies showing 41-75% involvement of the apical and near apical tissue with prostate cancer and an additional 5-43% prostatic involvement by the bladder TCC [20,21], we recommend complete removal of prostate at radical cystoprostatectomy for bladder cancer.…”

Radikal sistoprostatektomi yapılan hastalarda prostat kanseri insidansı ve klinik önemi

“…Prostat kanserinin haritalandırılması ile ilgili çalışmalarda prostat apeksinin %41-75 gibi yüksek bir oranla en sık tutulum yeri olduğu ve mesanedeki değişici epitel hücreli karsinomunun prostat dokusuna invazyon sıklığının %5-43 olduğu gösterilmiştir (27,28). Çalışmamızda ise 126 hastanın 19'unda (%15) mesane değişici epitel hücreli karsinomunun prostat dokusuna invazyonu saptanmıştır ve literatür ile uyumludur.…”

Treatment of Carcinoma in situ of the Urethra with Intraurethral Instillations of Bacillus Calmette-Guérin

“…TCC of the prostatic urethra is difficult to treat and carries an ominous prognosis [16]. Cystoprostatourethrectomy is the recom mended treatment.…”