TY - JOUR
T1 - Frequency and prognostic significance of incidental prostate cancer at radical cystectomy
T2 - Results from an international retrospective study
AU - Malte, Rieken
AU - Kluth, Luis A.
AU - Kaushik, Dharam
AU - Boorjian, Stephen A.
AU - Abufaraj, Mohammad
AU - Foerster, Beat
AU - Rink, Michael
AU - Gust, Kilian
AU - Roghmann, Florian
AU - Noldus, Joachim
AU - Vordos, Dimitri
AU - Hagiwara, Masayuki
AU - Kikuchi, Eiji
AU - Ikeda, Masaomi
AU - Matsumoto, Kazumasa
AU - Karakiewicz, Pierre I.
AU - Rouprêt, Morgan
AU - Briganti, Alberto
AU - Scherr, Douglas S.
AU - Shariat, Shahrokh F.
AU - Seebacher, Veronika
N1 - Publisher Copyright:
© 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
PY - 2017/11
Y1 - 2017/11
N2 - Objectives To analyze the frequency of incidental prostate cancer (PC) at radical cystoprostatectomy (RC) for urothelial carcinoma of the bladder (UCB) and its association with survival outcomes in an international cohort. Patients and methods In this retrospective study, we included 2114 who underwent RC and lymphadenectomy for UCB between 1976 and 2012 male patients from seven institutions. Univariable and multivariable Cox regression models addressed the association of incidental PC with cancer-specific mortality and overall mortality after RC. Results Overall, incidental PC was found in 513 (24.3%) patients with the lowest frequency in a Japanese center (23/164, 11.2%) and the highest frequency in a North American center (122/325, 37.5%), respectively (p < 0.001). Within a median follow up of 27 months (IQR: 50 months), 20 patients (3.9%) were diagnosed with biochemical recurrence (BCR) and none of the patients died of PC. PC pathological tumor stage was more advanced in patients experiencing BCR (p < 0.001). In multivariable Cox regression analyses adjusted for standard clinicopathologic features, incidental PC was not associated with cancer-specific (HR: 1.11, 95% CI: 0.91–1.35, p = 0.30) or overall mortality (HR: 1.06, 95% CI: 0.83–1.35, p = 0.65). Conclusions Incidental PC at RC for UCB is a frequent event. However, the majority of PC cases are well-differentiated and organ-confined. Presence of incidental PC shows significant geographic differences. The risk of BCR after incidental PC is low and incidental PC is not associated with survival in UCB patients treated with RC.
AB - Objectives To analyze the frequency of incidental prostate cancer (PC) at radical cystoprostatectomy (RC) for urothelial carcinoma of the bladder (UCB) and its association with survival outcomes in an international cohort. Patients and methods In this retrospective study, we included 2114 who underwent RC and lymphadenectomy for UCB between 1976 and 2012 male patients from seven institutions. Univariable and multivariable Cox regression models addressed the association of incidental PC with cancer-specific mortality and overall mortality after RC. Results Overall, incidental PC was found in 513 (24.3%) patients with the lowest frequency in a Japanese center (23/164, 11.2%) and the highest frequency in a North American center (122/325, 37.5%), respectively (p < 0.001). Within a median follow up of 27 months (IQR: 50 months), 20 patients (3.9%) were diagnosed with biochemical recurrence (BCR) and none of the patients died of PC. PC pathological tumor stage was more advanced in patients experiencing BCR (p < 0.001). In multivariable Cox regression analyses adjusted for standard clinicopathologic features, incidental PC was not associated with cancer-specific (HR: 1.11, 95% CI: 0.91–1.35, p = 0.30) or overall mortality (HR: 1.06, 95% CI: 0.83–1.35, p = 0.65). Conclusions Incidental PC at RC for UCB is a frequent event. However, the majority of PC cases are well-differentiated and organ-confined. Presence of incidental PC shows significant geographic differences. The risk of BCR after incidental PC is low and incidental PC is not associated with survival in UCB patients treated with RC.
KW - Incidental prostate cancer
KW - Outcomes
KW - Radical cystoprostatectomy
KW - Urothelial carcinoma of the bladder
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UR - http://www.scopus.com/inward/citedby.url?scp=85029467604&partnerID=8YFLogxK
U2 - 10.1016/j.ejso.2017.08.013
DO - 10.1016/j.ejso.2017.08.013
M3 - Article
C2 - 28928012
AN - SCOPUS:85029467604
SN - 0748-7983
VL - 43
SP - 2193
EP - 2199
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 11
ER -