Incidental prostate cancer at the time of cystectomy: the incidence and clinicopathological features in Chinese patients.
OBJECTIVE
To evaluate the incidence and the clinicopathological features of incidental prostate cancer detected in radical cystoprostatectomy (RCP) specimens in Chinese men and to estimate the oncological risk of prostate apex-sparing surgery for such patients.


METHODS
The clinical data and pathological feature of 504 patients who underwent RCP for bladder cancer from January 1999 to March 2013 were retrospectively reviewed. Whole mount serial section of the RCP specimens were cut transversely at 3-4 mm intervals and examined in same pathological institution.


RESULTS
Thirty-four out of 504 patients (6.8%) had incidental prostate cancer with a mean age of 70.3 years. 12 cases (35.2%) were diagnosed as significant disease. 4 cases were found to have apex involvement of adenocarcinoma of the prostate while in 5 cases the prostate stroma invasion by urothelial carcinoma were identified (one involved prostate apex). The mean follow-up time was 46.4±33.8 months. Biochemical recurrence occurred in 3 patients but no prostate cancer-related death during the follow-up. There was no statistical significance in cancer specific survival between the clinically significant and insignificant cancer group.


CONCLUSIONS
The prevalence of incidental prostate cancer in RCP specimens in Chinese patients was remarkably lower than in western people. Most of the incidental prostate cancer was clinically insignificant and patient's prognosis was mainly related to the bladder cancer. Sparing the prostate apex was potentially associated with a 1.0% risk of leaving significant cancer of the prostate or urothelial carcinoma.
Department of Urology, Renji Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Jiahua
J
Pan
Department of Urology, Renji Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Wei
W
Xue
Department of Urology, Renji Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Jianjun
J
Sha
Department of Urology, Renji Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Hu
H
Yang
Department of Urology, Renji Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Fan
F
Xu
Department of Urology, Renji Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Hanqing
H
Xuan
Department of Urology, Renji Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Dong
D
Li
Department of Urology, Renji Hospital, Affiliated to Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Yiran
Y
Huang
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002295:Carcinoma, Transitional Cell / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015653:Cystectomy; D005500:Follow-Up Studies; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology / Q000601:surgery; D011468:Prostatectomy / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012307:Risk Factors; D016019:Survival Analysis; D001743:Urinary Bladder / Q000473:pathology / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*