Primary multiple prostate and bladder cancer in patients undergone radical cystoprostatectomy

Abstract

Objective: The morbidity of multiple urological malignances is steadily grown. Incidental prostate cancer in patients with bladder cancer seems to be fairly often. This is one of the reasons of that the question of partial sparing of prostate in patients undergone radical cystoprostatectomy is still discussable. Purpose: The present study is designed to evaluate the incidence of simultaneous prostate and bladder cancer in patients undergoing radical cystoprostatectomy in Moscow Scientific Research Institute of Oncology.

Materials and methods: From 1994 to 2005, 113 men (mean age 59,5 years), with no evidence of prostatic malignancy on preoperative clinical and biochemical assessment, underwent cystoprostatectomy for TCC of the bladder in our institute. The bladder was adequately sampled and the entire prostate sectioned at 5-mm intervals and examined histologically, in order to identify unsuspected prostatic cancer (PCa).

Results: 10 out of 113 patients (8,8%) were found to have PCa. Four (3,5%) had cr. in situ, five (4,4%) had high grade prostatic intraepithelial neoplasia (PIN). All tumors were clinically significant, except cr. in situ and PIN. Almost all tumors (7,9%) were organ confined (pT2a—T2c), except one (0,9%), which was locale advanced (pT3a). Glaeson score was 2—4 in 5 (26,3%) and 5—7 in 5 (26,3%).

Conclusions: Incidental PCa is quite a common finding in cystoprostatectomy specimens of bladder cancer patients. This demands careful and complete excision of the prostate in patients with muscular-invasive bladder cancer.