[Can the prostatic capsule be preserved during cystectomy for bladder tumors: a study of urethral and prostatic involvement in the cystectomy specimens].
OBJECTIVE
To evaluate the frequency of urethral and prostatic lesions on cystectomy specimens for bladder tumour.


METHODS
This retrospective histological study was based on 260 specimens: radical cystectomies performed in 7 operative sites. The prostate and urethra were analysed in 3 planes (upper, middle and lower thirds). The apex was studied separately. Urethral invasion was identified by continuity of the tumour or by the presence of vesical CIS.


RESULTS
Urethral involvement is frequent (30.6% cases) essentially due to contiguous invasion (43/80). CIS is the second pathological association (44 urethral CIS/75 bladder CIS). Prostatic adenocarcinoma was present in 17.8% of cases with a Gleason score > 6 for 30% of lesions.


CONCLUSIONS
The high frequency of urethral and prostatic involvement does not justify preservation of the prostate during cystectomy. A serial prospective study should define the precise criteria able to minimize the risk of conservative surgery.
Plante
P
P
Groupe Tumeur de vessie infiltrante du CCAFU, Service d'Urologie, CHU Rangueil, Toulouse, France.
Lesourd
A
A
Blanchet
P
P
Castagnola
C
C
Coloby
P
P
Daffer
N
N
Davin
J L
JL
Desgrandchamps
F
F
Irani
J
J
Marechal
J M
JM
Mottet
N
N
Pariente
J L
JL
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000473:pathology / Q000601:surgery; D015653:Cystectomy / Q000379:methods*; D005069:Evaluation Studies as Topic; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology / Q000601:surgery*; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D014523:Urethral Neoplasms / Q000473:pathology* / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*
Peut-on préserver la coque prostatique au cours des cystectomies pour tumeur de vessie: étude de l'atteinte urétrale et prostatique sur les pièces de cystectomie.