Should prostate cancer status be determined in patients undergoing radical cystoprostatectomy?
BACKGROUND
We estimate the frequency of prostate cancers detected incidentally in radical cystoprostatectomy specimens and discuss whether the prostate cancer status should be determined in patients undergoing radical cystoprostatectomy.


METHODS
A total of 97 radical cystoprostatectomies without evidence of prostate cancer on digital rectal examination were performed for transitional cell carcinomas of the bladder between January 2001 and May 2004. The mean patient age at the time of surgery was 66.9 +/- 9.52 (range 49-75) years.


RESULTS
The overall incidence of prostate cancer detected in radical cystoprostatectomy specimens was 21.6% (21/97 specimens). The mean tumor volume was found to be 0.93 +/- 0.81 ml. The tumor volume was >0.5 ml in 12 cases (57.1%). The surgical margin was negative in all cases, and the disease was organ confined in 20 patients (95.2%). Capsular invasion was evident in 2 patients (9.5%), 1 of whom had lymph-node-positive disease.


CONCLUSIONS
Despite the high prevalence of incidental prostate carcinomas among patients with bladder cancer undergoing cystoprostatectomy, the vast majority of the cancers are organ confined. However, the prostate cancer status should be determined on the basis of digital rectal examination and prostate-specific antigen in patients undergoing radical cystoprostatectomy - especially if prostate-sparing cystectomy is planned.
Sanli
Oner
O
Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. sanlio@istanbul.edu.tr
Acar
Omer
O
Celtik
Murad
M
Oktar
Tayfun
T
Kilicaraslan
Isin
I
Ozcan
Faruk
F
Tunc
Murat
M
Esen
Tarik
T
D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology*; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000601:surgery; D015653:Cystectomy; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000473:pathology*; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery