Assessment of 5-year overall survival in bladder cancer patients with incidental prostate cancer identified at radical cystoprostatectomy.

Abstract

OBJECTIVE:

To investigate the oncological impact of incidental prostate cancer (iPCa) found during radical cystoprostatectomy (RCP) on overall survival (OS) prognosis of urothelial carcinoma of the bladder (BCa).

PATIENTS AND METHODS:

A total of 122 RCP cases resected between 2002 and 2012 at our center were included for study. Survival of BCa patient was compared using the Kaplan-Meier method and the log-rank test. Cox proportional hazards regression models were used to analyze the impact of iPCa on the 5-year overall mortality of BCa patients after RCP.

RESULTS:

Among the 122 BCa cases that underwent RCP, 38 cases (31.1%) had iPCa, in which, 17 cases (44.7%) were identified as clinically significant iPCa (csPCa). BCa patients with iPCa were older (71 vs 64 years, p = 0.004) and had higher preoperative PSA level (3.1 ng/mL vs 1.4 ng/mL, p = 0.017) when compared to those without iPCa. Cases with iPCa showed a more favorable 5-year OS than cases without iPCa, although this difference did not reach statistical significance (p = 0.219). When excluding the higher risk cases with Gleason score (GS) ≥ 4 + 3 and/or preoperative PSA > 10 ng/mL, BCa patients with iPCa showed a significantly longer OS than cases without iPCa on univariate analysis (p = 0.044), but not on multivariate analysis (p = 0.125).

CONCLUSION:

Our results demonstrated that the frequent findings of low-risk iPCa in BCa patients could indicate the potential possibility of shared pathogenesis pathways between iPCa and BCa. Future study with a larger cohort is warranted to validate this result.

• Authors: Shulin Wu, Sharron X Lin, Min Lu, Alexander O Subtelny, Zongwei Wang, Douglas M Dahl, Aria F Olumi, Chin-Lee Wu
• Journal: International urology and nephrology (Int Urol Nephrol) Vol. 51 Issue 9 Pg. 1527-1535 (Sep 2019) ISSN: 1573-2584 [Electronic] Netherlands
• PMID: 31183659 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Carcinoma, Transitional Cell (mortality, surgery)
• Cystectomy
• Humans
• Incidental Findings
• Male
• Middle Aged
• Prognosis
• Prostatectomy
• Prostatic Neoplasms (diagnosis, mortality)
• Survival Rate
• Time Factors
• Urinary Bladder Neoplasms (mortality, surgery)