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Incidentally Found Prostate Cancer and Influence on Overall Survival after Radical Cystoprostatectomy

DOI: 10.1155/2012/690210

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Abstract:

Objectives. To determine incidentally found prostate cancer frequency and impact on overall survival after RCP. Patients and Methods. The records of 81 men who underwent cystoprostatectomy from January 2000 to December 2009 were reviewed. The vital status of the study group was assessed as on September 1, 2009, by passive followup, using data from the population registry. Results. The 81 men underwent RCP. The incidental prostate cancer was found in the specimens of 27 (33.3%) patients. 13 (48.1%) of 27 prostate cancer cases were clinically significant. For 3 patients (11.1%) an extraprostatic extension was found. For 2 patients (7.4%)—positive margins, for 1 patient (3.7%)—Gleason sum 8, and for the rest 7 patients bigger than 0.5?cm3 volume tumor, and Gleason sum 7 was found. The mean follow-up time was months (varies from 0.8 to 131.2 months). The patients with bladder cancer and incidentally found prostate cancer lived shorter ( and months). Higher overall survival ( ) was found in the patient group with bladder cancer without incidentally diagnosed prostate cancer. Conclusion. There are indications that in this small study prostate cancer has influenced on patients' survival with bladder cancer after radical cystoprostatectomy. 1. Introduction Bladder cancer is the second most common cancer of urinary tract after prostate cancer and the fourth most common malignancy in men [1]. Although the disease may occur in young persons, about 78% of all cancers are diagnosed in persons of age 55 years and older [2]. 70% of all patients with bladder cancer have superficial cancer that does not reach the muscular layer, and most of these patients have a fairly good prognosis. Most of the patients with superficial bladder cancer have pTa bladder cancer stage. 20% of all patients with bladder cancer have pT1 bladder cancer stage and just 10% is carcinoma in situ [3]. Patients with carcinoma in situ have the biggest risk of cancer progression into the muscular layer and also are in the biggest risk group of death. Radical cystoprostatectomy (RCP) is the standard and effective treatment method for the patients with invasive or superficial recurrent bladder cancer who are in a high progression risk group. Patients’ survival after RCP depends on the primary tumor grade and stage. 5-year survival after RCP varies from 33 to 73%, and no other medical attempts during the last 10 years had no influence for patients’ survival [4]. The standart technique of RCP in men consists of removing a bladder together with the removal of a prostate, seminal vesicles, a part of the

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