Synchronous bladder and prostate cancer specimens obtained from radical cystoprostatectomy: A single‑center retrospective analysis

Baio,Raffaele; Molisso,Giovanni; Caruana,Christian; Di Mauro,Umberto; Intilla,Olivier; Pane,Umberto; D'Angelo,Costantino; Campitelli,Antonio; Pentimalli,Francesca; Sanseverino,Roberto

doi:10.3892/etm.2023.11872

Synchronous bladder and prostate cancer specimens obtained from radical cystoprostatectomy: A single‑center retrospective analysis

Authors:
- Raffaele Baio
- Giovanni Molisso
- Christian Caruana
- Umberto Di Mauro
- Olivier Intilla
- Umberto Pane
- Costantino D'Angelo
- Antonio Campitelli
- Francesca Pentimalli
- Roberto Sanseverino
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Affiliations: Department of Medicine and Surgery, ‘Salerno Medical School’, University of Salerno, I‑84081 Salerno, Italy, Department of Urology, ‘Umberto I’ Hospital of Nocera Inferiore, Nocera Inferiore, I‑84014 Salerno, Italy, Department of Chemistry, University of Malta, Msida MSD 2080, Malta, Department of Medical Biotechnologies, University of Siena, I‑53100 Siena, Italy, Department of Medicine and Surgery, Free Mediterranean University (LUM University), I‑70010 Bari, Italy
Published online on: March 6, 2023 https://doi.org/10.3892/etm.2023.11872
Article Number: 173
Copyright: © Baio et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of the present study was to analyze incidence, histopathological features and clinical outcomes of patients undergoing radical cystoprostatectomy (RCP) for bladder cancer, in which incidental prostate cancer (PCa) was found. How these types of cancer impacted the patients' management and whether prostate‑sparing cystectomy could be an option for these patients was determined. The current study retrospectively analyzed the data of a cohort of patients from ‘Umberto I’ Hospital of Nocera Inferiore who underwent RCP for bladder transitional cell carcinoma. Patients with a preoperative diagnosis or clinical suspicion of PCa were excluded. Patients affected by incidental PCa in the RCP specimens were identified, and then their demographic, histopathological and clinical outcome data were collected. Overall, it was revealed that of the 303 patients undergoing RCP for bladder cancer, 69 (22.7%) had incidental PCa, with a median age of 71.6 (age range, 54‑89 years). In total, 23 (33.33%) of the 69 patients with incidental PCa were considered to have clinically significant prostate disease. In conclusion, it was relatively common to identify incidental PCa in RCP specimens but no preoperative predictive factors were identified that were able to determine ‘non‑aggressive’ PCa status. Therefore, the present results demonstrate the need for a careful and complete prostate removal during RCP. Nevertheless, since organ‑sparing surgeries are widely performed in young population, due to the impossibility of predicting aggressive prostate cancer, these patients require close monitoring through lifelong PSA surveillance, particularly focusing on the possible relapse of PCa after RCP.

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1	Devesa SS, Blot WJ, Stone BJ, Miller BA, Tarone RE and Franmeit JF Jr: Recent cancer trends in the United States. J Natl Cancer Inst. 87:175–182. 1995.PubMed/NCBI View Article : Google Scholar
2	Wingo PA, Tong T and Bolden S: Cancer statistics 1995. CA Cancer J Clin. 45:8–30. 1995.PubMed/NCBI View Article : Google Scholar
3	Winkler MH, Livni N, Mannion EM, Hrouda D and Christmas T: Characteristics of incidental prostatic adenocarcinoma in contemporary radical cystoprostatectomy specimens. BJU Int. 99:554–558. 2007.PubMed/NCBI View Article : Google Scholar
4	Konski A, Rubin P, Disantagnese PA, Mayer E, Keys H, Cockett A, Frank I, Davis R and Lush C: Simultaneous presentation of adenocarcinoma of prostate and transitional cell carcinoma of bladder. Urology. 37:202–206. 1991.PubMed/NCBI View Article : Google Scholar
5	Witjes JA, Compérat E, Cowan NC, De Santis M, Gakis G, Lebret T, Ribal MJ, Van der Heijden AG and Sherif A: European Association of Urology. EAU guidelines on muscle-invasive and metastatic bladder cancer: summary of the 2013 guidelines. Eur Urol. 65:778–792. 2014.PubMed/NCBI View Article : Google Scholar
6	Nieuwenhuijzen JA, Meinhardt W and Horenblas S: Clinical outcomes after sexuality preserving cystectomy and neobladder (prostate sparing cystectomy) in 44 patients. J Urol. 173:1314–1317. 2005.PubMed/NCBI View Article : Google Scholar
7	Heidenreich A, Aus G, Bolla M, Joniau S, Matveev VB, Schmid HP and Zattoni F: European Association of Urology. EAU guidelines on prostate cancer. Eur Urol. 53:68–80. 2008.PubMed/NCBI View Article : Google Scholar
8	Lopez-Beltran A, Mikuz G, Luque RJ, Mazzucchelli R and Montironi R: Current practice of Gleason grading of prostate carcinoma. Virchows Arch. 448:111–118. 2006.PubMed/NCBI View Article : Google Scholar
9	Scott R Jr, Matchnik DH, Laskowski TZ and Schmalforst WR: Carcinoma of the prostate in elderly men: Incidence, growth characteristics and clinical significance. J Urol. 101:602–607. 1969.PubMed/NCBI View Article : Google Scholar
10	Cabalin JN, McNeal JF, Price HM, Freiha FS and Stamey TA: Unsuspected adenocarcinoma of the prostate in patients undergoing cystoprostatectomy for other causes: Incidence, histology and morphometric observations. J Urol. 141:1091–1094. 1989.PubMed/NCBI View Article : Google Scholar
11	Montie JE, Wood DR Jr, Pontes E, Boyett JM and Levin HS: Adenocarcinoma of the prostate in cystoprostatectomy specimens removed for bladder cancer. Cancer. 63:381–385. 1989.PubMed/NCBI View Article : Google Scholar
12	Chun TY: Coincidence of bladder and prostate cancer. J Urol. 157:65–67. 1997.PubMed/NCBI
13	Stein JP, Lieskovsky G, Cote R, Groshen S, Feng AC, Boyd S, Skinner E, Bochner B, Thangathurai D, Mikhail M, et al: Radical cystectomy in the treatment of invasive bladder cancer: Long-term results in 1,054 patients. J Clin Oncol. 19:666–675. 2001.PubMed/NCBI View Article : Google Scholar
14	Damiano R, Di Lorenzo G, Cantiello F, De Sio M, Perdonà S, D'Armiento M and Autorino R: Clinicopathologic features of prostate adenocarcinoma incidentally discovered at the time of radical cystectomy: An evidence-based analysis. Eur Urol. 52:648–657. 2007.PubMed/NCBI View Article : Google Scholar
15	Ploussard G, Epstein JI, Montironi R, Carroll PR, Wirth M, Grimm MO, Bjartell AS, Montorsi F, Freedland SJ, Erbersdobler A and van der Kwast TH: The contemporary concept of significant versus insignificant prostate cancer. Eur Urol. 60:291–303. 2011.PubMed/NCBI View Article : Google Scholar
16	Greenberg RS, Rustin ED and Clark S: Risk of genitourinary malignancies after cancer of the prostate. Cancer. 61:396–401. 1988.PubMed/NCBI View Article : Google Scholar
17	Liskow AS, Neugut AI, Benson M, Olsson CA, Birkhoff J and Chang GH: Multiple primary neoplasms in association with prostate cancer in black and white patients. Cancer. 59:380–384. 1987.PubMed/NCBI View Article : Google Scholar
18	Kotake T and Kiyohama H: Multiple primary cancers (MPC) associated with bladder cancer: An analysis of the clinical and autopsy cases in Japan. Jpn J Clin Oncol. 15 (Suppl 1):S201–S210. 1985.PubMed/NCBI
19	Kantor AF and McLaughlin JK: Second cancer following cancer of the urinary system in Connecticut, 1935-82. Natl Cancer Inst Monogr. 68:149–159. 1985.PubMed/NCBI
20	Mersheimer WL, Ringel A and Eisenberg H: Some characteristics of multiple primary cancers. Ann NY Acad Sci. 114:896–921. 1964.PubMed/NCBI
21	Barbisan F, Mazzucchelli R, Scarpelli M, Lopez-Beltran A, Cheng L, Kirkali Z and Montironi R: Urothelial and incidental prostate carcinoma in prostates from cystoprostatectomies for bladder cancer: Is there a relationship between urothelial and prostate cancer? BJU Int. 103:1058–1063. 2009.PubMed/NCBI View Article : Google Scholar
22	Kurokawa K, Ito K, Yamamoto T, Takechi H, Miyamoto S, Suzuki K and Yamanaka H: Comparative study on the prevalence of clinically detectable prostate cancer in patients with and without bladder cancer. Urology. 63:268–272. 2004.PubMed/NCBI View Article : Google Scholar
23	Kouriefs C, Fazili T, Masood S, Naseem MS and Mufti GR: Incidentally detected prostate cancer in cystoprostatectomy specimens. Urol Int. 75:213–216. 2005.PubMed/NCBI View Article : Google Scholar
24	Abbas F, Hochberg D, Givantos F and Soloway M: Incidental prostatic adenocarcinoma in patients under-going radical cystoprostatectomy for bladder cancer. Eur Urol. 30:322–326. 1996.PubMed/NCBI View Article : Google Scholar
25	Moutzouris G, Barbatis C, Plastiras D, Mertziotis N, Katsifotis C, Presvelos V and Theodorou C: Incidence and histological findings of unsuspected prostatic adenocarcinoma in radical cystoprostatectomy for transitional cell carcinoma of the bladder. Scand J Urol Nephrol. 33:27–30. 1999.PubMed/NCBI
26	Revelo MP, Cookson MS, Chang SS, Shook MF, Smith JA Jr and Shappell SB: Incidence and location of prostate and urothelial carcinoma in prostates from cystoprostatectomies: Implications for possible apical sparing surgery. J Urol. 171:646–651. 2004.PubMed/NCBI View Article : Google Scholar
27	Hautmann SH, Conrad S, Henke RP, Erbersdobler A, Simon J, Straub M, Graefen M, Hautmann RE and Huland H: Detection rate of histologically insignificant prostate cancer with systematic sextant biopsies and fine needle aspiration cytology. J Urol. 163:1734–1738. 2000.PubMed/NCBI
28	Pettus JA, Al-Ahmadie H, Barocas DA, Koppie TM, Herr H, Donat SM, Dalbagni G, Reuter VE, Olgac S and Bochner BH: Risk assessment of prostatic pathology in patients undergoing radical cystoprostatectomy. Eur Urol. 53:370–375. 2008.PubMed/NCBI View Article : Google Scholar
29	Gakis G, Schilling D, Bedke J, Sievert KD and Stenzl A: Incidental prostate cancer at radical cystoprostatectomy: Implications for apex-sparing surgery. BJU Int. 105:468–471. 2010.PubMed/NCBI View Article : Google Scholar