Outcome of patients with fortuitous prostate cancer after radical cystoprostatectomy for bladder cancer.

OBJECTIVES: To analyze the outcome of patients after fortuitous diagnosis of prostate cancer (PCa) on cystoprostatectomy (CPT) specimen.

METHODS: The medical charts of 141 male patients who underwent radical CPT for urothelial cell carcinoma of the bladder between january 1995 and april 2000 were retrospectively reviewed. None of the patients had preoperative clinical or biological suspicion of PCa.

RESULTS: Pathological examination of the CPT specimens showed PCa in 20 patients (14.2%). Of these, 6 had a microfocal PCa, 10 had a pT2a tumour, 2 had a pT2b tumour, and 2 had a pT3a tumour. The Gleason score was < or =5 in 5 cases, 6 in 13 cases, and 7 in 2 cases. Two patients were lost to follow-up. Ten patients died of bladder cancer after a median follow-up of 13 months. Eight patients remained free of disease after a median follow-up of 64.5 months. None of the 20 patients experienced PCa recurrence during follow-up.

CONCLUSIONS: In our experience, the rate of unsuspected PCa on cystoprostatectomy specimens was 14.2%. The majority of these PCas were organ-confined, and there was no PCa recurrence during follow-up.