Defining patient selection for prostate-sparing cystectomy in squamous cell carcinoma of the urinary bladder associated with bilharziasis: an overview of 236 patients.
OBJECTIVE
To determine possible risk factors associated with prostate invasion in patients with squamous cell carcinoma (SCC) of the urinary bladder associated with bilharziasis.


METHODS
After obtaining approval from the medical ethics committee, we reviewed the clinical and pathologic data from 236 male patients in our department between January 2006 and October 2010 who were treated with radical cystoprostatectomy and proved to have SCC associated with bilharziasis. We reviewed the clinical and histopathologic data regarding prostate infiltration from SCC of the urinary bladder associated with bilharziasis.


RESULTS
Two-hundred thirty-six patients were included in this study. Prostate infiltration was present in 14 patients (5.9%). Tumor located in the bladder neck (P = .000001), tumors >5 cm (P = .009), and advanced clinical tumor stage (P = .000001) were associated with highly statistically significant increased risk of prostate invasion from SCC of the urinary bladder. Different patients' ages, high tumor grade, and regional lymph nodes' metastasis were not associated with increased risk of prostate invasion from SCC of the urinary bladder.


CONCLUSIONS
Prostate infiltration from SCC of the urinary bladder (which is associated with bilharziasis) is not uncommon. Tumor >5 cm, bladder neck tumor, and high clinical tumor stages should be considered at least relative contraindications for prostate-sparing cystectomy.
Department of Urology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Yaser M
YM
Abdelsalam
Ahmad A
AA
Mokhtar
Adel A
AA
Kurkar
Medhat A
MA
Saleh
Ehab O
EO
el-Ganainy
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D015653:Cystectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D059351:Organ Sparing Treatments; D018579:Patient Selection; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D012552:Schistosomiasis / Q000150:complications; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D055815:Young Adult