Incidental Prostate Cancer Frequency and Features of Patients Undergoing Radical Cystoprostatectomy

Abstract

Objective: Prostate cancer (PC) is one of the major health problems among males. Pathology specimens of patients with incidental PC who underwent radical cystoprostatectomy (RCP) have been reported to be 17-70% in different series. In this study, we aimed to determine the frequencies and features of incidental PC in patients who underwent RCP.Methods: In our study, 142 patients who underwent RCP were retrospectively evaluated between 1999 and 2015. Women and patients diagnosed with PC before were excluded. Preoperative PSA levels were 2.05-9.31 ng/mL. Standard RSP and standard pelvic lymphadenectomy were performed.Results: Incidental PC was detected in 22 of 142 patients. The frequency of incidental PC was found to be 15.4% in RSP materials. In 10 of 22 patients with PC, high-grade prostatic intraepithelial neoplasia (PIN) areas were detected. Further, 14 of 120 patients without PC had highgrade PIN zones. In 140 patients, transitional cell carcinoma was detected, and the other 2 patients had signet ring cell carcinoma. In bladder specimens, 68 patients were in the T2 stage, while 58 patients and 16 patients were in the T3 and T4 stages, respectively. The Gleason score (GS) was 2+3=5 in 2 of the 22 incidental PC patients. Moreover, 6 patients had GS of 3+2=5 and 14 patients had GS of 3+3=6. Conclusion:Most incidentally detected PCs in RCP specimens are small, localized, and well-differentiated tumors. Extracapsular extension was not observed in any of them. Patients with invasive bladder tumors and PCs together have a lower T stage than those with only invasive bladder tumors. The risk of PC is higher in patients with invasive bladder cancer than in the healthy population. Preoperative prostate evaluation, prostate dissection, and resection should be performed with oncologic surgery. (JAREM 2016; 6: 15-8)