title: Concomitant Gleason Score ≥ 7 prostate cancer is an independent prognosticator for poor survival in nonmetastatic bladder cancer patients undergoing radical cystoprostatectomy.
abstract: OBJECTIVE
  In bladder cancer (BCa) patients undergoing radical cystoprostatectomy (RCPx), concomitant prostate cancer (PCa) is a common finding. Up to now there is no clear evidence to suggest that concomitant PCa is a predictor of outcome in these patients. Aim of this study was to assess incidence and clinicopathologic characteristics of concomitant PCa in RCPx specimen and correlate it to survival parameters from a single-centre material over two decades.
  
  
  METHODS
  All men who had undergone RCPx for BCa at our institution between 1994 and 2013 were included in this study. Clinicopathologic parameters for BCa and PCa were evaluated and correlated with outcome parameters. Survival analysis was performed for the subgroup of nonmetastatic organ-confined BCa to evaluate the role of concomitant Gleason Score (GS) ≥7 PCa.
  
  
  RESULTS
  Of 945 men who had undergone RCPx for BCa, concomitant PCa was present in 237 patients (25.1 %). There was a significant increase in PCa incidence from 18.9 to 32.3 % between 1994 and 2013 (p = 0.009). Concomitant PCa represented a more aggressive phenotype at the end of the study (p = 0.037). In nonmetastatic organ-confined BCa, concomitant GS ≥7 PCa (HR 3.09; p = 0.0001) and age > 68 (HR 1.80; p = 0.0004) were independent negative predictors for overall survival.
  
  
  CONCLUSIONS
  Concomitant PCa in RCPx specimen of BCa patients is a common finding. The incidence of concomitant PCa has significantly increased within 2 decades, presenting a more aggressive phenotype. Age and in particular concomitant GS ≥7 PCa are independent prognosticators for poor survival in patients with nonmetastatic organ-confined BCa.
authors.affiliation: Department of Urology, University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany. thomasch@uni-mainz.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Thomas
authors.affiliation: Department of Urology, University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Giesswein
authors.affiliation: Department of Pathology, University of Mainz, Mainz, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Hainz
authors.affiliation: Department of Urology, University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
authors.forename: Raimund
authors.initials: R
authors.lastname: Stein
authors.affiliation: Department of Urology, University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Rubenwolf
authors.affiliation: Department of Urology, University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
authors.forename: Frederik C
authors.initials: FC
authors.lastname: Roos
authors.affiliation: Department of Urology, University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Neisius
authors.affiliation: Department of Urology, University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Nestler
authors.affiliation: Department of Urology, University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Hampel
authors.affiliation: Department of Urology, University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Jäger
authors.affiliation: Department of Urology, University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.|Department of Urology, KRH Hospital Siloah-Oststadt-Heidehaus, Hannover, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Wiesner
authors.affiliation: Department of Urology, University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
authors.forename: Joachim W
authors.initials: JW
authors.lastname: Thüroff
mesh_terms: D000367:Age Factors; D000368:Aged; D015653:Cystectomy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009378:Neoplasms, Multiple Primary / Q000401:mortality*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery
keywords: Bladder cancer; Concomitant prostate cancer; Cystoprostatectomy; Survival