ABSTRACT
Radical cystectomy is the most effective therapeutic approach for patients with muscle-invasive bladder cancer. Due to the incidence of sexual and continence complications associated with this procedure, alternative techniques such as cystectomy with partial prostatectomy have been described in selected cases in order to reduce complications. To evaluate the possible oncological risks of prostate-sparing cystectomy, and to determine the associated pathological findings in the prostate for patients with invasive bladder cancer treated by radical cystoprostatectomy.Between 1/1/2009 and 30/6/2010, 146 patients with urothelial bladder carcinoma who were candidates for Radical cystectomy were retrospectively evaluated. Patient and tumor characteristics were evaluated.The median patient age was 62 years [range: 38-72]. Prostatic adenocarcinoma was detected in 5 of the 146 [3.42%] patients. There was prostatic involvement as a result of direct invasion by the primary bladder tumor in 10 cases [6.85%]. Concomitant transitional cell carcinoma of the prostatic urethra was detected in 9 specimens [6.17%]. Additional findings were high-grade prostatic intraepithelial neoplasia in 6 patients [4.11%] and benign prostatic hyperplasia in 98 [67.12%]. The percentage of incidentally detected Prostatic adenocarcinoma in radical cystectomy specimens in our study is much lower than the reported rates in Western countries. Using the standard technique, with thin slices taken from the whole gland, a higher incidence of prostate cancer can be discovered. Our study supplement the importance of appropriate case selection for those undergoing prostate-sparing cystectomy, and the careful selection of cystectomy and diversion type for each case depending on the clinical and pathological data
ABSTRACT
Bladder cancer is the second most common urogenital tumor. The stage, grade, number and diameter of urinary bladder cancer is an important factors in determining prognosis of the disease. Early diagnosis and proper treatment are also critical to improve survival. This retrospective study was performed to determine the clinico-pathological features of primary bladder cancer at first presentation at Damascus University hospitals. From Jan 2009 to June 2010, we retrospectively evaluated 96 patients with primary bladder cancer. All patients were evaluated with regards to clinical presentation, cystoscopic findings and histo-pathological data. Our study population [96 patients] comprised 18.75% females and 81.25% males. The median age was 62 years [range:38-72], 62 patients [64.58%] had history of cigarette smoking. Most patients [82.29%] presented with painless hematuria. Primary transitional cell carcinoma was the most common [i.e. 94.79%] histological variety of bladder carcinoma. We found that 23.96% of patients had [Ta] cancer, 41.67% had tumor with subepithelial connective tissue invasion [T1], 34.38% of patients had muscle invasive tumors [>/=T2] and 5.21% were associated with [CIS] at the time of presentation. Regional or distant metastases were found in 6.25% of patients. Well differentiated tumor [G1] was seen in 33.33% of the patients, moderately differentiated tumor [G2] was found in 29.17% and poorly differentiated tumor [G3] was found in 37.5% of the patients. Most bladder tumours in our study are TCCs, and majority of them are in T1 stage. They are more common in men than in women and the incidence increases with age. Macroscopic hematuria is the most common symptom. Awareness is needed among the public and treating physicians as they tend to neglect the symptoms of hematuria, resulting in an advanced stage of bladder cancer at presentation. And the situation can be further improved by the awareness about smoking risks, adopting proper screening programs and performing appropriate investigations
ABSTRACT
Radical cystectomy is the most effective therapeutic approach for patients with muscleinvasive bladder cancer. Accurate staging is important for treatment planning, and prognostication. This study retrospectively compared TNM staging before and after radical cystectomy in a series of patients with bladder cancer. Between 1/1/2007 and 30/12/2009, 162 patients with urothelial bladder carcinoma who were candidates for Radical cystectomy with curative intent were retrospectively evaluated. Preoperative clinical and pathological [i.e. TURBT] features were compared to pathological outcomes in the cystectomy specimen [TNM staging before and after radical cystectomy]. Our study population comprised 7.41% females and 92.59% males. The median patient age was 65 years [range: 40-73]. In 70.37% of patients radical cystectomy was indicated after the progression of an initially superficial bladder carcinoma. In the other 29.63% of patients, bladder neoplasms were muscle-invasive at the time of initial diagnosis. The median time interval between diagnosis of muscle invasion and radical cystectomy was 4 weeks [range: 0-72]. T staging of the primary tumour before radical cystectomy was recurrent multifocal [CIS] or [cT1] in 16.05%, [cT2] in 44.44%, [cT3] in 29.63% and [cT4] stage in 9.88% of patients. Whereas T staging after radical cystectomy was distributed as follows: 9.88% of patients had stage