Incidental prostate cancer detected in cystoprostatectomy specimens in patients treated with radical cystectomy for bladder cancer

Charalampos Fragkoulis, Georgios Katsagounos, Konstantinos Stasinopoulos, Georgios Stathouros, Georgios Papadopoulos, Konstantinos Ntoumas

Abstract


Introduction: Prostate cancer (PCa) is a major global health concern as it is the most frequently diagnosed malignancy in both Europe and USA with greater proportion in elder men. Bladder cancer is the second most common malignancy of the urinary system after PCa. The purpose of this article is to report the prevalence, the characteristics and the clinical significance of incidental PCa in bladder cancer patients treated with radical cystectomy in our department.

Methods: We reviewed data from 64 patients who underwent radical cystectomy as during the years 2012 and 2013 in our department. Prostate cancer was described as clinical significant when there were positive surgical margins, extraprostatic extension, Gleason score > 6 or tumor volume ≥ 0.5 cm3.

Results : Incidental PCa was diagnosed in 22 patients (34.3%), 16 were diagnosed with Gleason score 6 disease (72.7%), 5 with Gleason score 7 (22.7%) and 1 with Gleason score 8 (4.6%). The mean age of PCa patients was 70.1 years. Extraprostatic extension was present in 2 patients (9.2%) and positive surgical margins in one patient (4.6%). Moreover in 2 patients the PCa tumor volume was above 0.5 cm3. As a result, 8 patients were diagnosed with clinical significant incidental PCa.

 

Σκοπός: Ο καρκίνος του προστάτη αποτελεί την συχνότερα διαγνωσμένη κακοήθεια σε άνδρες στην Ευρώπη και τις ΗΠΑ με μεγαλύτερη επίπτωση σε μεγάλες ηλικίες. Ο καρκίνος της ουροδόχου κύστης αποτελεί την δεύτερη σε συχνότητα κακοήθεια του ουροποιητικού. Σκοπός της μελέτης η καταγραφή της συχνότητας και της κλινικής σημασίας καρκίνου προστάτη ως τυχαίο εύρημα σε ασθενείς που υποβάλλονται σε ριζική κυστεκτομή ως θεραπεία καρκίνου κύστης.

Μέθοδος: Αναλύθηκαν τα δεδομένα 64 ασθενών που υποβλήθηκαν σε ριζική κυστεκτομή κατά τα έτη 2012 και 2013 στο τμήμα μας. Κλινικά σημαντικός καρκίνος προστάτη ορίσθηκε όταν υπήρχαν θετικά χειρουργικά όρια, εξωπροστατική επέκταση,  Gleason score > 6 ή όγκος νεοπλάσματος ≥ 0,5 cm3.

Αποτελέσματα: Καρκίνος προστάτη ως τυχαίο εύρημα διαγνώσθηκε σε 22 ασθενείς (34,3%), 16 παρουσίασαν Gleason score 6 (72,7%), 5 Gleason score 7 (22,7%) και 1 Gleason score 8 (4,6%). Η μέση ηλικία ήταν 70,1 έτη. Εξωπροστατική επέκταση ανιχνεύτηκε σε 2 ασθενείς (9,2%) και θετικά χειρουργικά όρια σε έναν (4,6%) ενώ 2 είχαν νεοπλασματικό όγκο ≥ 0,5 cm3. Συνολικά, 8 ασθενείς διαγνώσθηκαν με κλινικά σημαντικό καρκίνο προστάτη.


Keywords


prostate cancer; bladder cancer; radical cystectomy; καρκίνος προστάτη; καρκίνος ουροδόχου κύστης; ριζική κυστεκτομή

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DOI: http://dx.doi.org/10.19264/hj.v28i4.155