A Preliminary Research of Cystoprostatectomy on Patients with Prostate Cancer Extending to Bladder

Abstract

Background This is an exploratory research of cystoprostatectomy (CP) in treating prostate cancer (PCa) extending to bladder, which aimed to evaluate the effects of CP on long-term survival outcomes and improving quality of life (QoL) on these patients. Methods A total of 27 PCa patients extending to bladder were subjected to CP and followed-up at regular intervals in our center. Prostate cancer-specific survival (PCSS) and prostate specific antigen (PSA) recurrence-free survival (PFS) were assessed by Kaplan-Meier analysis. Multivariate Cox regression was performed to evaluate clinical characteristics predicting survivals. QoL and pelvic symptoms were also evaluated. Results Median follow-up was 42.0 months. Five patients (18.5%) died as a direct result of tumor progression. Median PCSS was not reached over the period of follow-up. 5-year PCSS rate was 82.1%. PSA recurrence after surgery was observed in 11 patients (40.7%). Median PFS was 66.0 months. 5-year PFS rate was 58.5%. Multivariate analysis showed Gleason score (≥ 8) (hazard ratio (HR) 2.55, 95% confidence interval (CI) 1.28–4.04, p = 0.033), positive local lymph node status (HR 3.52, 95% CI 1.57–7.38, p = 0.006) and bladder muscle-invasion (HR 4.75, 95% CI 1.37–7.53, p < 0.001) were independent predictors of worse PCSS. The number of patients suffering pelvic symptoms was significantly decreased, and QoL scores were significantly down-regulated after surgeries. Conclusion CP offered effective and durable palliation in patients of locally advanced prostate cancer with invasion of bladder, providing better QoL and relieving local symptoms.