[Results of prostate pathology in patients undergoing radical cystectomy]

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