Clinicopathological Features Of103Cases Of Bladder Cancer Combined With Incidental Prostate Cancer

Objective:To investigate the incidence and clinicopathological features of incidental prostate cancer (IPCa) in radical cystoprostatectomy (RCP) specimens for bladder cancer, so as to improve the diagnosis and treatment for bladder cancer combined with IPCa.Methods:The prostate specimens and clinical data of786cases who underwent RCP between January2004and June2014in the First Affiliated Hospital of Zhejiang University were analysed retrospectively. All patients underwent digital rectal examination (DRE) and ultrasonography and serum PSA test and chest X-ray. No patients had preoperative clinical or biological suspicion of PCa.Results:IPCa was diagnosed in103of786(103/786,13.10%) cases. Most tumors (100/103,97.09%) were organ-confined (≤pT2); And3cases (3/103,2.91%) were diagnosed at pT3. Gleason score was≤6in87cases (87/103,84.47%), and≥7in16cases (16/103,15.53%). The incidence of IPCa increased with age (P<0.05). Of these IPCa patients,26cases (26/103,25.24%) were clinically significant according to an accepted definition. No significant differences were found in the serum PSA level between patients with IPCa and these without IPCa, nor between patients with significant IPCa and insignificant IPCa(P>0.05).96patients with IPCa were followed up at a mean follow-up period of (38.60±17.37)months. Biochemical recurrence occured in6patients (6/96,6.25%). Significant differences were found in the rate of biochemical recurrence between the clinically significant and insignificant IPCa group(P<0.01). None of these ICPa patients died of IPCa. No significant differences were found in cancer specific survival between the clinically significant and insignificant IPCa group (P>0.05).Conclusion:The incidence of IPCa in RCP specimens was13.10%, which increased with age. Most IPCas in RCP specimens were organ-confined and well-differentiated. Fully drawn of prostate tissue in RCP specimens can improve the detection rate of IPCa. In order to reduce the missed diagnosis of IPCa, a comprehensive examination of prostate should be taken to patients who undergo RCP, especially in these patients over the age of60. Serum PSA level cannot identify asymptomatic PCa prior to RCP, but it is helpful in the prediction of prognosis of IPCa. IPCa doesn’t impact the prognosis of bladder cancer patients undergoing RCP.