Incidental prostate cancer diagnosed at radical cystoprostatectomy for bladder cancer: disease-specific outcomes and survival

Joshua B Kaelberer; Michael A O'Donnell; Darrion L Mitchell; Anthony N Snow; Sarah L Mott; John M Buatti; Mark C Smith; John M Watkins

doi:10.1016/j.prnil.2016.06.002

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Incidental prostate cancer diagnosed at radical cystoprostatectomy for bladder cancer: disease-specific outcomes and survival

Journal article

Open access

Peer reviewed

Incidental prostate cancer diagnosed at radical cystoprostatectomy for bladder cancer: disease-specific outcomes and survival

Joshua B Kaelberer, Michael A O'Donnell, Darrion L Mitchell, Anthony N Snow, Sarah L Mott, John M Buatti, Mark C Smith and John M Watkins

Prostate international, Vol.4(3), pp.107-112

09/2016

DOI: 10.1016/j.prnil.2016.06.002

PMCID: PMC5031900

PMID: 27689068

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Abstract

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. 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. 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. 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.

Prostate neoplasms

Bladder neoplasms

Cystoprostatectomy

Details

Title: Subtitle: Incidental prostate cancer diagnosed at radical cystoprostatectomy for bladder cancer: disease-specific outcomes and survival
Creators: Joshua B Kaelberer - Department of Radiation Oncology, University of Iowa, Carver College of Medicine, Iowa City, IA, USA
Michael A O'Donnell - Department of Urology, University of Iowa, Carver College of Medicine, Iowa City, IA, USA
Darrion L Mitchell - Department of Radiation Oncology, University of Iowa, Carver College of Medicine, Iowa City, IA, USA
Anthony N Snow - Department of Pathology, University of Iowa, Carver College of Medicine, Iowa City, IA, USA
Sarah L Mott - Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
John M Buatti - Department of Radiation Oncology, University of Iowa, Carver College of Medicine, Iowa City, IA, USA
Mark C Smith - Department of Radiation Oncology, University of Iowa, Carver College of Medicine, Iowa City, IA, USA
John M Watkins - Department of Radiation Oncology, University of Iowa, Carver College of Medicine, Iowa City, IA, USA
Resource Type: Journal article
Publication Details: Prostate international, Vol.4(3), pp.107-112
DOI: 10.1016/j.prnil.2016.06.002
PMID: 27689068
PMCID: PMC5031900
NLM abbreviation: Prostate Int
ISSN: 2287-8882
eISSN: 2287-903X
Publisher: Elsevier B.V
Language: English
Date published: 09/2016
Academic Unit: Pathology; Radiation Oncology; Urology; Neurosurgery; Otolaryngology
Record Identifier: 9984040342202771

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