Department of Urology, The Adelaide and Meath Hospital Incorporating The National Children's Hospital, Tallaght, Dublin 24, Ireland.
Int Urol Nephrol. 2012 Dec;44(6):1705-10. doi: 10.1007/s11255-012-0224-y. Epub 2012 Jul 7.
To review the incidence, histopathological features and clinical outcomes of patients with incidental prostate cancer (CaP) found in cystoprostatectomy specimens (CP) excised for bladder cancer and to determine whether these prostate cancers could affect the follow-up strategy.
We retrospectively reviewed the records of 110 patients who underwent CP for bladder cancer (1998-2011) at our institution. CaP grade, stage, volume and surgical margin status were recorded. Prostatic involvement by bladder tumour or carcinoma in situ (CIS) was studied. Pre-operative prostate assessment and follow-up in those diagnosed with incidental CaP were analysed.
Incidental CaP was identified in 35 patients (32.5%), 4 with prostatic PIN alone and 2 patients with diagnoses of CaP prior to cystectomy were excluded from study. Of the CaP cases, 28.5% had clinically significant disease: 5 with Gleason score 7, 2 with Gleason score 9, who also had extracapsular invasion of tumour, and three with positive surgical margins. All patients were pN0 for CaP. Of the 108 patients, 16.5% had prostatic urethral involvement with CIS or TCC. In the subgroup of patients with the incidentally diagnosed CaP who developed local recurrence of bladder tumour and/or metastatic disease, none originated from their CaP.
The majority of incidental CaP in CP specimens are organ confined and do not influence oncological outcome. The prognosis of such patients is primarily determined by bladder cancer. Our findings support previous reports and autopsy studies elsewhere.
回顾在因膀胱癌行膀胱根治性切除术（RC）时切除的膀胱前列腺切除术标本（CP）中偶然发现的前列腺癌（CaP）的发生率、组织病理学特征和临床结果，并确定这些前列腺癌是否会影响随访策略。
我们回顾性分析了 110 例在我院因膀胱癌行 CP （1998-2011 年）的患者的记录。记录了 CaP 分级、分期、体积和手术切缘状态。研究了膀胱肿瘤或原位癌（CIS）对前列腺的累及情况。分析了诊断为偶然 CaP 的患者的术前前列腺评估和随访情况。
35 例患者（32.5%）偶然发现 CaP，其中 4 例仅有前列腺上皮内瘤变（PIN），2 例在 RC 前诊断为 CaP 被排除在研究之外。CaP 病例中，28.5%有临床显著疾病：5 例 Gleason 评分 7，2 例 Gleason 评分 9，且均有肿瘤包膜外侵犯，3 例有切缘阳性。所有患者的 CaP 均为 pN0。108 例患者中有 16.5%的前列腺尿道有 CIS 或 TCC 累及。在偶然诊断为 CaP 并发生膀胱癌局部复发和/或转移疾病的患者亚组中，均未源自其 CaP。
CP 标本中偶然发现的 CaP 大多数局限于器官内，不影响肿瘤学结果。此类患者的预后主要取决于膀胱癌。我们的研究结果支持其他地方的先前报道和尸检研究。
