title: High incidence of clinically significant concomitant prostate cancer in patients undergoing radical cystectomy for bladder cancer: A 10-year single-center experience.
abstract: To analyze prostate cancer (PCa) incidence, clinical significance, and recurrence in 213 patients who underwent radical cystectomy (RC) for advanced bladder cancer (BC).
  
  
  
  We conducted a 10-year retrospective analysis of a single-center database comprising the effect of PCa in RC specimens.
  
  
  
  In total, 113/213 male patients (53.1%) had PCa in the RC specimen. Patients׳ age, prostate-specific antigen (PSA), and also free PSA% were significant predictors for PCa. In addition, adverse bladder histology (≥pT3) was found in 63.7% of patients with PCa. A total of 52.2% (59/113) of patients had at least a Gleason score (GS) 7 in final pathology and 10.6% of RC specimens showed an organ border growth (≥pT3a). It was noted that 28.3% of patients experienced a biochemical recurrence (PSA≥0.2ng/ml), among them 86.7% had GS≥7 in the RC specimen; however, 2 patients were diagnosed with a GS 5. Moreover, we found that 80% of patients with biochemical recurrence had an organ-extended (≥pT3) histology of the bladder and 40% of patients with biochemical recurrence died of PCa rather than from BC.
  
  
  
  Concomitant PCa is occurring in>50% of RC specimens with a significant proportion having characteristics (GS, pathological stage) of clinically relevant disease. Adverse bladder histology is a risk factor for both PCa and biochemical PSA recurrence. Follow-up analyses after RC should include PSA measurements also in low-risk PCa as a considerable number of patients develop biochemical recurrence and metastases from PCa partly ending up with death related to PCa in patients suffering from BC.
authors.affiliation: Department of Urology, Medical University Innsbruck, Innsbruck, Austria. Electronic address: Isabel-maria.heidegger@tirol-kliniken.at.
authors.forename: Isabel
authors.initials: I
authors.lastname: Heidegger
authors.affiliation: Department of Clinical Epidemiology, Tyrolean State Hospitals, Cancer Registry of Tyrol, Tyrol, Austria.
authors.forename: Willi
authors.initials: W
authors.lastname: Oberaigner
authors.affiliation: Department of Urology, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Horninger
authors.affiliation: Department of Urology, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Renate
authors.initials: R
authors.lastname: Pichler
mesh_terms: D000368:Aged; D001317:Austria / Q000453:epidemiology; D015653:Cystectomy / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008197:Lymph Node Excision / Q000009:adverse effects*; D008297:Male; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000453:epidemiology*; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*
keywords: Biochemical recurrence; Bladder cancer; Free PSA; Incidental prostate cancer; PSA; Prostate cancer–specific mortality; Radical cystectomy