Clinicopathological characteristics of incidental prostate cancer discovered from radical cystoprostatectomy specimen: a multicenter French study

Géraldine Pignot, Laurent Salomon, Yann Neuzillet, Alexandra Masson-Lecomte, Cédric Lebacle, Jean-Jacques Patard, Pierre Lunardi, Pascal Rischmann, Gilles Pasticier, Jean-Christophe Bernhard, Jérémy Cohen, Marc-Olivier Timsit, Virginie Verkarre, Benoit Peyronnet, Gregory Verhoest, Constance Le Goux, Marc Zerbib, François Brecheteau, Pierre Bigot, Stéphane Larre, Thibault Murez, Rodolphe Thuret, Emeric Lacarriere, Cécile Champy, Morgan Roupret, Eva Comperat, Julien Berger, Aurélien Descazeaud, Harry Toledano, Cyrille Bastide, Sébastien Lavilledieu, Christophe Avances, Francky Delage, Antoine Valeri, Benoit Molimard, Alain Houlgatte, Pascal Gres, Alain Donnaint, François Kleinclauss, Sophie Legal, Arnaud Doerfler, Nicolas Koutlidis, Luc Cormier, Jean-François Hetet, Philippe Colls, Alexis Arvin-Berod, Jean-Jacques Rambeaud, Hervé Quintens, Michel Soulie, Christian Pfister
Annals of Surgical Oncology 2014, 21 (2): 684-90

PURPOSE: The present study assessed the incidence and histopathological features of incidentally diagnosed prostate cancer (PCa) in specimens from radical cystoprostatectomy (RCP) for bladder cancer. The patient outcomes also were evaluated.

METHODS: We retrospectively reviewed the histopathological features and survival data of 4,299 male patients who underwent a RCP for bladder cancer at 25 French centers between January 1996 and June 2012. No patients had preoperative clinical or biological suspicion of PCa.

RESULTS: Among the 4,299 RCP specimens, PCa was diagnosed in 931 patients (21.7%). Most tumors (90.1%) were organ-confined (pT2), whereas 9.9% of them were diagnosed at a locally advanced stage (≥pT3). Gleason score was <6 in 129 cases (13.9%), 6 in 575 cases (61.7%), 7 (3 + 4) in 149 cases (16.0%), 7 (4 + 3) in 38 cases (4.1%), and >7 in 40 cases (4.3%). After a median follow-up of 25.5 months (interquartile range 14.2-47.4), 35.4% of patients had bladder cancer recurrence and 23.8% died of bladder cancer. Only 16 patients (1.9%) experienced PCa biochemical recurrence during follow-up, and no preoperative predictive factor was identified. No patients died from PCa.

CONCLUSIONS: The rate of incidentally diagnosed PCa in RCP specimens was 21.7%. The majority of these PCas were organ-confined. PCa recurrence occurred in only 1.9% of cases during follow-up.

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