title: Oncologic aspects of long-term followed incidental prostate cancer detected by cystoprostatectomy in Korean patients.
abstract: OBJECTIVE
  To determine the incidence and clinical features of incidentally discovered prostate adenocarcinoma in patients undergoing radical cystoprostatectomy (CPT) for bladder cancer.
  
  
  METHODS
  Ninety-six consecutive patients scheduled to undergo CPT were prospectively enrolled. The prostates were excised completely during CPT. The CPT specimens were examined, and the clinicopathologic characteristics of incidental prostate cancer studied. Complete transverse sections of the prostate were taken from the apex to the base at 4-mm intervals and all prostates were examined by a single pathologist.
  
  
  RESULTS
  The mean patient age and prostate-specific antigen level were 66.1 ± 10.0 years and 2.8 ± 5.0 ng/mL, respectively. Of the 96 patients, 35 (36.5%) had prostate cancer (PCa). Of these incidental PCas, 57.1% (20.8% of all patients undergoing CPT) were clinically significant. None of the patients who were age ≤50 years had incidental PCa. However, the incidences of PCa in the 51-60 years, 61-70 years, and ≥71 years age groups were 27.8% (5/18), 48.7% (19/39), and 35.5% (15/31), respectively, and the difference according to the age subgroup was significant (P = 0.048). During the median follow-up of 49 months, 29.2% (28/96) of patients died. There were no PCa-specific deaths, and two patients (2.1%) showed biochemical recurrences.
  
  
  CONCLUSIONS
  Incidental PCas were diagnosed in ∼40% of CPT specimens, and ∼50% of incidental PCas were clinically significant. During radical CPT in patients aged ≥60 years, the possibility of the presence of PCa and the potential oncologic risk of partial prostatectomy during CPT should be remembered.
authors.affiliation: Department of Urology, National Police Hospital, Seoul, Korea.
authors.forename: In-Chang
authors.initials: IC
authors.lastname: Cho
authors.affiliation: Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Jeong Eun
authors.initials: JE
authors.lastname: Kim
authors.affiliation: Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Sung Han
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Joung
authors.affiliation: Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Ho Kyung
authors.initials: HK
authors.lastname: Seo
authors.affiliation: Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Jinsoo
authors.initials: J
authors.lastname: Chung
authors.affiliation: Department of Pathology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Weon Seo
authors.initials: WS
authors.lastname: Park
authors.affiliation: Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea.
authors.forename: Kang Hyun
authors.initials: KH
authors.lastname: Lee
keywords: Cystectomy; Incidence; Prostate cancer