Abstract

BACKGROUND:

The impact of incidental prostate cancer (IPC) on oncological outcomes after radical cystoprostatectomy (RCP) specimens from patients with bladder cancer (BC) remains controversial. This relationship has not been well elucidated in Asian countries, where the incidence of prostate cancer has recently shown dramatic increases.

OBJECTIVES:

This study retrospectively compared pathological features and oncological outcomes between BC patients with and without IPC in the RCP specimens.

METHODS:

This study included 142 men who underwent RCP for BC. Men who were previously diagnosed with prostate cancer were excluded. Each prostate gland and seminal vesicle was processed as whole mounts and 4-mm close-step sectioning was performed. A single genitourinary pathologist diagnosed IPC. The pathological features and oncological outcomes such as overall survival (OS), bladder cancer-specific survival (BCSS), and progression-free survival (PFS) were compared between patients with IPC (IPC+group, n = 45) and without IPC (IPC- group, n = 97). P values less than 0.05 considered to indicate statistical significance for patients’ characteristics. Because of multi-primary endpoint, P values less than 0.0167 was considered statistical significance for oncological outcomes.

RESULTS:

We detected IPC in 45 RCP specimens (31.6%). Patients in the IPC- group were significantly younger at surgery than those in the IPC+group (P < 0.001). The pathological features of the RCP specimens did not differ significantly. In multivariable analyses, presence of IPC was significantly associated with worse OS (P = 0.005), but not with either BCSS or PFS (P = 0.038 and 0.326, respectively). In Kaplan–Meier analyses, OS tended to be longer in the IPC- group than that in the IPC+group (NR vs 65 months, P = 0.0017).

CONCLUSIONS:

Our results suggested significantly better OS in patients without IPC than that in those with IPC.

中文翻译：

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根治性膀胱切除术标本中的偶然前列腺癌与总体生存期较差有关

摘要

背景：

膀胱癌（BC）患者进行根治性膀胱前列腺切除术（RCP）标本后，偶然性前列腺癌（IPC）对肿瘤结局的影响仍存在争议。这种关系在亚洲国家中还没有得到很好的阐明，在亚洲国家中，前列腺癌的发病率最近显示出急剧上升的趋势。

目标：

这项研究回顾性地比较了RCP标本中有无IPC的BC患者之间的病理特征和肿瘤学结局。

方法：

这项研究包括142例接受过RCP的男性。先前被诊断患有前列腺癌的男性被排除在外。将每个前列腺和精囊整体处理，并进行4毫米近距离切片。一名泌尿生殖系统病理学家诊断出IPC。比较了IPC患者（IPC +组，n  = 45）和无IPC患者的病理学特征和肿瘤学结局，例如总生存期（OS），膀胱癌特异性生存期（BCSS）和无进展生存期（PFS）（ IPC-组，n  = 97）。P值小于0.05被认为表明对患者特征具有统计学意义。由于存在多个主要终点，因此P 小于0.0167的值被认为对肿瘤结局具有统计学意义。

结果：

我们在45个RCP标本中检测到IPC（31.6％）。IPC-组的患者比IPC +组的患者年轻得多（P  <0.001）。RCP标本的病理特征没有显着差异。在多变量分析中，IPC的存在与较差的OS显着相关（P  = 0.005），而与BCSS或PFS均不相关（ 分别为P = 0.038和0.326）。在Kaplan–Meier分析中，IPC-组的OS倾向于比IPC +组的OS长（NR vs 65个月，P  = 0.0017）。

结论：

我们的结果表明，没有IPC的患者的OS显着好于IPC的患者。