[Cavernosal metastases from bladder tumour after cystoprostatectomy].
OBJECTIVE
To evaluate the predictive factors for cavernosal metastases after cystoprostatectomy for transitional cell bladder cancer.


METHODS
Between February 1998 and January 2002, 61 men were treated by cystectomy for transitional cell bladder cancer (56 total cystoprostatectomies and 5 partial cystectomies). Five patients (8%) subsequently developed cavernosal metastases. The assessment criteria were classified into three categories: clinical history, histological findings on the operative specimen and follow-up data.


RESULTS
The metastasis was observed an average of 8.4 months (range: 3-17) after cystoprostatectomy. Three of the 5 patients had a history of transurethral procedure at the same time as resection of a high-grade invasive bladder tumour: a urethral recurrence concomitant with the penile metastasis was observed in these cases. In 4 out of 5 cases, the bladder tumour was multifocal, involving the bladder neck, extensive and high-grade (> or = pT3 G3). Vascular tumour emboli were detected on the cystoprostatectomy specimen in 4 cases. All urethral sections performed during cystectomy were negative. All 5 patients died with a mean survival of 7 months (range: 1 to 21 months).


CONCLUSIONS
The development of penile metastases after cystectomy appears to be frequently associated with the presence of extensive tumour (> or = pT3) on the operative specimen, involving the bladder neck, with a high histoprognostic grade and with the presence of tumour embolus. No transurethral procedures should be performed at the same time as resection of an obviously invasive bladder tumour. Health urethral sections do not exclude the risk of penile metastases.
Service d'Urologie et de Transplantation Rénale et Pancréatique, Hôpital de la Pitié, Paris, France.
Fabrice
F
Mondet
Soufiane
S
Mkaouar
Emmanuel
E
Chartier-Kastler
Marc-Olivier
MO
Bitker
Annick
A
Delcourt
François
F
Richard
D002295:Carcinoma, Transitional Cell / Q000556:secondary* / Q000601:surgery; D015653:Cystectomy; D006801:Humans; D008297:Male; D010412:Penile Neoplasms / Q000556:secondary*; D011468:Prostatectomy; D012189:Retrospective Studies; D012307:Risk Factors; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery