title: The incidence and relevance of prostate cancer in radical cystoprostatectomy specimens.
abstract: OBJECTIVE
  To review the incidence, histopathological features and clinical outcomes of patients with incidental prostate cancer (CaP) found in cystoprostatectomy specimens (CP) excised for bladder cancer and to determine whether these prostate cancers could affect the follow-up strategy.
  
  
  METHODS
  We retrospectively reviewed the records of 110 patients who underwent CP for bladder cancer (1998-2011) at our institution. CaP grade, stage, volume and surgical margin status were recorded. Prostatic involvement by bladder tumour or carcinoma in situ (CIS) was studied. Pre-operative prostate assessment and follow-up in those diagnosed with incidental CaP were analysed.
  
  
  RESULTS
  Incidental CaP was identified in 35 patients (32.5%), 4 with prostatic PIN alone and 2 patients with diagnoses of CaP prior to cystectomy were excluded from study. Of the CaP cases, 28.5% had clinically significant disease: 5 with Gleason score 7, 2 with Gleason score 9, who also had extracapsular invasion of tumour, and three with positive surgical margins. All patients were pN0 for CaP. Of the 108 patients, 16.5% had prostatic urethral involvement with CIS or TCC. In the subgroup of patients with the incidentally diagnosed CaP who developed local recurrence of bladder tumour and/or metastatic disease, none originated from their CaP.
  
  
  CONCLUSIONS
  The majority of incidental CaP in CP specimens are organ confined and do not influence oncological outcome. The prognosis of such patients is primarily determined by bladder cancer. Our findings support previous reports and autopsy studies elsewhere.
authors: Department of Urology, The Adelaide and Meath Hospital Incorporating The National Children's Hospital, Tallaght, Dublin 24, Ireland.
authors: M
authors: M
authors: Alsinnawi
authors: B
authors: B
authors: Loftus
authors: R
authors: R
authors: Flynn
authors: T
authors: T
authors: McDermott
authors: R
authors: R
authors: Grainger
authors: J A
authors: JA
authors: Thornhill
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy; D006801:Humans; D015994:Incidence; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000601:surgery*