Department of Urology, Bicetre Academic Hospital, Paris XI University, Le Kremlin Bicêtre Cedex, France,
Ann Surg Oncol. 2014 Feb;21(2):684-90. doi: 10.1245/s10434-013-3340-8. Epub 2013 Oct 30.
The present study assessed the incidence and histopathological features of incidentally diagnosed prostate cancer (PCa) in specimens from radical cystoprostatectomy (RCP) for bladder cancer. The patient outcomes also were evaluated.
We retrospectively reviewed the histopathological features and survival data of 4,299 male patients who underwent a RCP for bladder cancer at 25 French centers between January 1996 and June 2012. No patients had preoperative clinical or biological suspicion of PCa.
Among the 4,299 RCP specimens, PCa was diagnosed in 931 patients (21.7%). Most tumors (90.1%) were organ-confined (pT2), whereas 9.9% of them were diagnosed at a locally advanced stage (≥pT3). Gleason score was <6 in 129 cases (13.9%), 6 in 575 cases (61.7%), 7 (3 + 4) in 149 cases (16.0%), 7 (4 + 3) in 38 cases (4.1%), and >7 in 40 cases (4.3%). After a median follow-up of 25.5 months (interquartile range 14.2-47.4), 35.4% of patients had bladder cancer recurrence and 23.8% died of bladder cancer. Only 16 patients (1.9%) experienced PCa biochemical recurrence during follow-up, and no preoperative predictive factor was identified. No patients died from PCa.
The rate of incidentally diagnosed PCa in RCP specimens was 21.7%. The majority of these PCas were organ-confined. PCa recurrence occurred in only 1.9% of cases during follow-up.
本研究评估了在因膀胱癌行根治性膀胱前列腺切除术（RCP）的标本中偶然诊断出的前列腺癌（PCa）的发生率和组织病理学特征。还评估了患者的结局。
我们回顾性分析了 1996 年 1 月至 2012 年 6 月在 25 个法国中心因膀胱癌行 RCP 的 4299 例男性患者的组织病理学特征和生存数据。所有患者术前均无 PCa 的临床或生物学可疑表现。
在 4299 例 RCP 标本中，931 例（21.7%）诊断为 PCa。大多数肿瘤（90.1%）为器官局限（pT2），而 9.9%的肿瘤诊断为局部晚期（≥pT3）。Gleason 评分<6 者 129 例（13.9%），6 分者 575 例（61.7%），7（3+4）分者 149 例（16.0%），7（4+3）分者 38 例（4.1%），>7 分者 40 例（4.3%）。中位随访 25.5 个月（四分位间距 14.2-47.4）后，35.4%的患者膀胱癌复发，23.8%死于膀胱癌。随访期间仅有 16 例（1.9%）患者发生 PCa 生化复发，且术前无预测因素。无患者死于 PCa。
RCP 标本中偶然诊断出的 PCa 发生率为 21.7%。这些 PCa 大多数为器官局限型。随访期间仅 1.9%的病例发生 PCa 复发。
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