title: Impact of Prostate Involvement on Outcomes in Patients Treated with Radical Cystoprostatectomy for Bladder Cancer.
abstract: OBJECTIVE
  The study aimed to evaluate the impact of the different types of prostate involvement at the time of radical cystoprostatectomy (RCP).
  
  
  METHODS
  Data from 893 male patients treated with RCP at a referral center for bladder cancer (BCa) were assessed. Prostatic urothelial carcinoma (PUC) was stratified as stromal vs. urethral/duct involvements. Multivariable Cox regression analyses were built to test the impact of the presence of incidental prostate cancer (PCa) and PUC on survival outcomes.
  
  
  RESULTS
  PCa was present in 319 (35.7%) RCP patients, of which 45 (14.1%) had significant PCa disease. PUC was identified in 181 patients (20%): 75 (41.1%) with urethral/duct involvement and 106 (58.6%) with stromal. Within a median follow-up of 72 months, stromal PUC, but not the other forms of PUC or PCa, was associated with worse survival outcomes. In multivariable analyses adjusted for the effects of standard features, stromal PUC remained associated with recurrence (hazards ratio [HR] 2.01, p = 0.03), cancer-specific mortality (HR 1.65, p = 0.01), and overall mortality (HR 1.45, p = 0.03).
  
  
  CONCLUSIONS
  Prostatic stromal invasion with urothelial carcinoma confers a poor survival expectation to BCa patients after surgical treatment. Conversely, other type of urothelial prostatic invasions or the presence of concomitant PCa does not seem to be associated with differences in survival outcomes.
authors.affiliation: Department of Urology, Urological Research Institute, Vita-Salute University, San Raffaele Scientific Institute, Catanzaro, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Moschini
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
authors.forename: Massimo
authors.initials: M
authors.lastname: Freschi
authors.forename: Francesco
authors.initials: F
authors.lastname: Soria
authors.forename: Mohammad
authors.initials: M
authors.lastname: Abufaraj
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gandaglia
authors.forename: Paolo
authors.initials: P
authors.lastname: Dell'Oglio
authors.forename: Agostino
authors.initials: A
authors.lastname: Mattei
authors.forename: Rocco
authors.initials: R
authors.lastname: Damiano
authors.forename: Andrea
authors.initials: A
authors.lastname: Salonia
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.forename: Alberto
authors.initials: A
authors.lastname: Briganti
authors.forename: Andrea
authors.initials: A
authors.lastname: Gallina
authors.forename: Renzo
authors.initials: R
authors.lastname: Colombo
mesh_terms: D000368:Aged; D015653:Cystectomy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D011184:Postoperative Period; D016016:Proportional Hazards Models; D011467:Prostate / Q000473:pathology; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000150:complications* / Q000601:surgery*; D012044:Regression Analysis; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000150:complications* / Q000601:surgery*; D019459:Urothelium / Q000473:pathology