The Risk Factors Study Of Bladder Cancer Encroaching Into The Prostate And Seminal Vesicle

Objectives:The aim of this study was to investigate the clinical evidence of prostate and seminal-sparing cystectomy by researching the risk factors of bladder cancer encroaching into the prostate and seminal vesicle.Methods:Seventy-eight male patients of bladder cancer were underwent open or laparoscopic radical cystectomy in The Second Affiliated Hospital of Kunming Medical University from May2013to April2014. The specimens after radical cystectomy include bladder and prostate were performed pathological examination, the entire prostate was submitted and processed with5-mm intervals coronal plane whole-mount step sections to apical. The clinical data and the pathological results of these patients were analyzed to identify whether the bladder cancer encroaching into the prostate or not and whether the risk factors including patient’s age, number of tumors (solitary or multiple),grade, stage, maximum diameter of tumor, position of tumor, the closest distance between the tumor to the bladder neck and lymphatic metastasis have the correlativity with the prostatic or seminal vesicle involvement or not.Results:The average age was61.23±11.46years old of the78bladder cancer cases, nine cases (11.5%) were encroached into the prostate, three cases (3.85%) were encroached into the seminal vesicle and thirteen cases (16.7%) had incidental prostate adenocancer. The statistical analysis showed that position of tumor,the closest distance between the tumor to the bladder neck, grade, stage, lymph nodes’ metastasis were significantly related to the prostatic involvement (P<0.05) in all risk factors of bladder cancer encroaching into the prostate, while patient’s age. maximum diameter of tumor, number of tumors were not significantly related to the prostatic involvement(P>0.05). Tumors located in the trigone or neck, multiple tumors, tumor diameter>4cm, lymph nodes positive were the risk factor for bladder tumor invasion seminal vesicle. In thirteen cases of bladder cancer with incidental prostatic adenocancer patients, all Gleason score of≤7and only found in pathological tiny or focal area of high-differentiated prostatic adenocancer,the risk factors was age and high tumor stage of bladder cancer (P<0.05)Conclusions:1. The risk factors of bladder cancer encroaching into the prostate were tumors located in bladder neck or trigone, close distance between the tumor to the bladder neck, high tumor grade, tumor stage greater than T3and lymph nodes positive2. Tumors located in the trigone or neck, multiple tumors, tumor diameter>4cm, lymph nodes positive were the risk factor for bladder tumor invasion seminal vesicle.3. Patient’s age and tumor stage greater than T2were found to be significantly related to the bladder cancer with incidental prostatic adenocancer.4. In order to ensure the operation result, pre-operation of the Prostate-sparing cystectomy should be strict screening, one of the operative indication of the prostate and seminal vesicle-sparing cystectomy were the younger, tumor not position in bladder neck or trigone, tumor diameter<4cm.far away from the bladder neck, low tumor stage.low tumor grade and lymph node negative...