Prostate cancer incidence on cystoprostatectomy specimens is directly linked to age: results from a multicentre study.
OBJECTIVE
To assess the incidence and age-related histopathological characteristics of incidentally diagnosed prostate cancer from specimens obtained via radical cystoprostatectomy (RCP) for muscle-invasive bladder cancer.


METHODS
A retrospective review of the histopathological features of 2424 male patients who underwent a RCP for bladder cancer was done at eight centres between January 1996 and June 2012. No patient had preoperative suspicion of prostate cancer. Statistical analyses were performed in different age-related groups.


RESULTS
Overall, prostate cancer was diagnosed in 518 men (21.4%). Incidences varied significantly according to age (5.2% in those aged <50 years to 30.5% in those aged >75 years, P < 0.001). Most of the prostate cancers were considered as 'non-aggressive', that is to say organ-confined (≤pT2) and well-differentiated (Gleason score <7). Tumour-Node-Metastasis (TNM) stage and proportion with a Gleason score of ≥7 were significantly greater in older patients (P < 0.001). Apart from age, there were no preoperative predictive factors for 'non-aggressive' prostate-cancer status. At the end of the follow-up, only nine patients (1.7%) had biochemical recurrence of prostate cancer, and no preoperative predictive factors were identified.


CONCLUSIONS
The rate of incidentally diagnosed prostate cancer from RCP specimens is ≈20%, most of them being organ-confined and well-differentiated. The probability of having a 'non-aggressive' prostate cancer decreases in older men.
Department of Urology, Bicetre Academic Hospital, Assistance Publique Hôpitaux de Paris, Paris XI University, Paris, France; Oncologic Committee of the French Association of Urology (CCAFU), Paris, France.
Géraldine
G
Pignot
Laurent
L
Salomon
Cédric
C
Lebacle
Yann
Y
Neuzillet
Pierre
P
Lunardi
Pascal
P
Rischmann
Marc
M
Zerbib
Cecile
C
Champy
Morgan
M
Roupret
Benoit
B
Peyronnet
Gregory
G
Verhoest
Thibault
T
Murez
Herve
H
Quintens
Stéphane
S
Larré
Nadine
N
Houédé
Eva
E
Compérat
Michel
M
Soulié
Christian
C
Pfister
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015653:Cystectomy; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery
cystoprostatectomy; incidentally detected; prognosis; prostatic neoplasms; urinary bladder neoplasms