Incidental prostate cancer diagnosed at radical cystoprostatectomy for bladder cancer: disease-specific outcomes and survival
| Autor: | Michael A. O’Donnell, Sarah L. Mott, Anthony N. Snow, Joshua B. Kaelberer, John M. Buatti, Mark C. Smith, D.L. Mitchell, John M. Watkins |
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| Rok vydání: | 2016 |
| Předmět: |
Disease specific
Oncology medicine.medical_specialty Urology medicine.medical_treatment 030232 urology & nephrology lcsh:RC870-923 Cystoprostatectomy 03 medical and health sciences Prostate cancer 0302 clinical medicine Bladder Neoplasm Internal medicine medicine Prostate neoplasms Bladder cancer Bladder neoplasms Radical cystoprostatectomy business.industry medicine.disease lcsh:Diseases of the genitourinary system. Urology 030220 oncology & carcinogenesis Referral center Original Article Prostate neoplasm business |
| Zdroj: | Prostate International, Vol 4, Iss 3, Pp 107-112 (2016) Prostate International |
| ISSN: | 2287-8882 |
| DOI: | 10.1016/j.prnil.2016.06.002 |
| Popis: | Background: The current standard of care for men with muscle-invasive bladder cancer is radical cystoprostatectomy (RCP). One-third of RCP specimens demonstrate incidental prostate cancer, primarily reported in small series with limited follow-up. The aim of this study is to report mature outcomes, including patterns of failure and disease-specific recurrence rates, and survival, for a large cohort of men with incidental prostate cancer at RCP performed at a tertiary referral center. Methods: This retrospective study describes cancer control and survival rates for men who underwent RCP for bladder cancer and were found incidentally to have prostate cancer. Analysis of patient-, tumor-, and treatment-specific factors were analyzed for association with disease control and survival endpoints. Results: Between 2002 and 2010, 94 patients with incidental discovery of prostate cancer postRCP were identified for inclusion in this study. Forty-five patients (45%) underwent RCP for recurrent (rather than initial presentation of) bladder carcinoma. At a median follow-up of 40.3 months (71.2 months for survivors; range, 8.9–155.5 months), 42 patients were alive without recurrence and 52 patients had died (25 associated with disease). The estimated 5-year bladder cancer disease-free, urinary tract malignancy disease-free, and prostate specific antigen (PSA) relapse-free survivals were 76% [95% confidence interval (CI), 65–84%], 64% (52–74%), and 97% (79–100%), respectively. The estimated 5-year urinary tract malignancy-specific and overall survivals were 61% (49–71%) and 52% (41–62%), respectively. Univariate analysis demonstrated associations between pathologic T/N-stage and nodal ratio with bladder cancer disease-free, urinary tract malignancy disease-specific, and overall survivals, with patient age at diagnosis as an additional adverse factor associated with overall survival. Multivariate analysis confirmed pN-stage and age as independently associated with worse survival. Conclusion: For men undergoing RCP for bladder cancer, the present study suggests that incidentally discovered prostate cancers, irrespective of pathologic stage, Gleason score, or clinical significance, do not impact 5-year disease control or survival outcomes. |
| Databáze: | OpenAIRE |
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