Risk Assessment of Prostatic Pathology in Patients Undergoing Radical Cystoprostatectomy

Joseph A. Pettus, Hikmat Al-Ahmadie, Daniel A. Barocas, Theresa Koppie, Harry Herr, S. Machele Donat, Guido Dalbagni, Victor E. Reuter, Semra Olgac, Bernard H. Bochner

Research output: Contribution to journalArticle

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Abstract

Objectives: To determine the incidence and location of prostate adenocarcinoma (PCa) and prostatic urothelial carcinoma (PUC) for patients undergoing radical cystoprostatectomy (RCP) for bladder cancer and to ascertain what preoperative information may be useful in predicting PUC or PCa in patients who may be candidates for prostate-sparing cystectomy. Methods: Between 2001 and 2004, 235 consecutive patients underwent RCP and had whole-mount sections of the prostate. We reviewed our prospective radical cystectomy database for preoperative clinicopathological information associated with each patient. The bladder and whole-mount prostate sections were re-reviewed to determine the location and depth of the bladder tumor as well as the presence of any associated PCa and PUC. Results: We identified 113 of 235 (48%) and 77 of 235 (33%) men with PCa and PUC, respectively. Among patients with PCa, 33 (29%) had Gleason score of ≥ 7, 25 (22%) had PCa tumor volume > 0.5 cc, and 15 (13%) had extracapsular extension. On multivariable analysis, only increasing age was significantly associated with PCa (odds ratio = 1.3, p = 0.046). Of the 77 with PUC, 28 (36%) had in situ disease only, while 49 (64%) had prostatic stromal invasion. Bladder tumor location in the trigone/bladder neck (p <0.001) and bladder carcinoma in situ (p <0.001) was strongly associated with PUC in the final specimen. Overall, 158 (67%) had either PCa or PUC in the prostate. Conclusions: PCa and/or PUC is present in a majority of RCP specimens. Current preoperative staging and tumor characteristics are not adequate for determining who can safely be selected for prostate-sparing cystectomy.

Original languageEnglish (US)
Pages (from-to)370-375
Number of pages6
JournalEuropean Urology
Volume53
Issue number2
DOIs
StatePublished - Feb 2008
Externally publishedYes

Fingerprint

Prostate
Pathology
Adenocarcinoma
Carcinoma
Cystectomy
Urinary Bladder Neoplasms
Urinary Bladder
Neoplasm Grading
Neoplasm Staging
Carcinoma in Situ
Tumor Burden
Odds Ratio
Databases

Keywords

  • Bladder cancer
  • Prostate cancer
  • Prostate-sparing cystectomy
  • Radical cystoprostatectomy

ASJC Scopus subject areas

  • Urology

Cite this

Pettus, J. A., Al-Ahmadie, H., Barocas, D. A., Koppie, T., Herr, H., Donat, S. M., ... Bochner, B. H. (2008). Risk Assessment of Prostatic Pathology in Patients Undergoing Radical Cystoprostatectomy. European Urology, 53(2), 370-375. https://doi.org/10.1016/j.eururo.2007.07.031

Risk Assessment of Prostatic Pathology in Patients Undergoing Radical Cystoprostatectomy. / Pettus, Joseph A.; Al-Ahmadie, Hikmat; Barocas, Daniel A.; Koppie, Theresa; Herr, Harry; Donat, S. Machele; Dalbagni, Guido; Reuter, Victor E.; Olgac, Semra; Bochner, Bernard H.

In: European Urology, Vol. 53, No. 2, 02.2008, p. 370-375.

Research output: Contribution to journalArticle

Pettus, JA, Al-Ahmadie, H, Barocas, DA, Koppie, T, Herr, H, Donat, SM, Dalbagni, G, Reuter, VE, Olgac, S & Bochner, BH 2008, 'Risk Assessment of Prostatic Pathology in Patients Undergoing Radical Cystoprostatectomy', European Urology, vol. 53, no. 2, pp. 370-375. https://doi.org/10.1016/j.eururo.2007.07.031
Pettus JA, Al-Ahmadie H, Barocas DA, Koppie T, Herr H, Donat SM et al. Risk Assessment of Prostatic Pathology in Patients Undergoing Radical Cystoprostatectomy. European Urology. 2008 Feb;53(2):370-375. https://doi.org/10.1016/j.eururo.2007.07.031
Pettus, Joseph A. ; Al-Ahmadie, Hikmat ; Barocas, Daniel A. ; Koppie, Theresa ; Herr, Harry ; Donat, S. Machele ; Dalbagni, Guido ; Reuter, Victor E. ; Olgac, Semra ; Bochner, Bernard H. / Risk Assessment of Prostatic Pathology in Patients Undergoing Radical Cystoprostatectomy. In: European Urology. 2008 ; Vol. 53, No. 2. pp. 370-375.
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abstract = "Objectives: To determine the incidence and location of prostate adenocarcinoma (PCa) and prostatic urothelial carcinoma (PUC) for patients undergoing radical cystoprostatectomy (RCP) for bladder cancer and to ascertain what preoperative information may be useful in predicting PUC or PCa in patients who may be candidates for prostate-sparing cystectomy. Methods: Between 2001 and 2004, 235 consecutive patients underwent RCP and had whole-mount sections of the prostate. We reviewed our prospective radical cystectomy database for preoperative clinicopathological information associated with each patient. The bladder and whole-mount prostate sections were re-reviewed to determine the location and depth of the bladder tumor as well as the presence of any associated PCa and PUC. Results: We identified 113 of 235 (48{\%}) and 77 of 235 (33{\%}) men with PCa and PUC, respectively. Among patients with PCa, 33 (29{\%}) had Gleason score of ≥ 7, 25 (22{\%}) had PCa tumor volume > 0.5 cc, and 15 (13{\%}) had extracapsular extension. On multivariable analysis, only increasing age was significantly associated with PCa (odds ratio = 1.3, p = 0.046). Of the 77 with PUC, 28 (36{\%}) had in situ disease only, while 49 (64{\%}) had prostatic stromal invasion. Bladder tumor location in the trigone/bladder neck (p <0.001) and bladder carcinoma in situ (p <0.001) was strongly associated with PUC in the final specimen. Overall, 158 (67{\%}) had either PCa or PUC in the prostate. Conclusions: PCa and/or PUC is present in a majority of RCP specimens. Current preoperative staging and tumor characteristics are not adequate for determining who can safely be selected for prostate-sparing cystectomy.",
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T1 - Risk Assessment of Prostatic Pathology in Patients Undergoing Radical Cystoprostatectomy

AU - Pettus, Joseph A.

AU - Al-Ahmadie, Hikmat

AU - Barocas, Daniel A.

AU - Koppie, Theresa

AU - Herr, Harry

AU - Donat, S. Machele

AU - Dalbagni, Guido

AU - Reuter, Victor E.

AU - Olgac, Semra

AU - Bochner, Bernard H.

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N2 - Objectives: To determine the incidence and location of prostate adenocarcinoma (PCa) and prostatic urothelial carcinoma (PUC) for patients undergoing radical cystoprostatectomy (RCP) for bladder cancer and to ascertain what preoperative information may be useful in predicting PUC or PCa in patients who may be candidates for prostate-sparing cystectomy. Methods: Between 2001 and 2004, 235 consecutive patients underwent RCP and had whole-mount sections of the prostate. We reviewed our prospective radical cystectomy database for preoperative clinicopathological information associated with each patient. The bladder and whole-mount prostate sections were re-reviewed to determine the location and depth of the bladder tumor as well as the presence of any associated PCa and PUC. Results: We identified 113 of 235 (48%) and 77 of 235 (33%) men with PCa and PUC, respectively. Among patients with PCa, 33 (29%) had Gleason score of ≥ 7, 25 (22%) had PCa tumor volume > 0.5 cc, and 15 (13%) had extracapsular extension. On multivariable analysis, only increasing age was significantly associated with PCa (odds ratio = 1.3, p = 0.046). Of the 77 with PUC, 28 (36%) had in situ disease only, while 49 (64%) had prostatic stromal invasion. Bladder tumor location in the trigone/bladder neck (p <0.001) and bladder carcinoma in situ (p <0.001) was strongly associated with PUC in the final specimen. Overall, 158 (67%) had either PCa or PUC in the prostate. Conclusions: PCa and/or PUC is present in a majority of RCP specimens. Current preoperative staging and tumor characteristics are not adequate for determining who can safely be selected for prostate-sparing cystectomy.

AB - Objectives: To determine the incidence and location of prostate adenocarcinoma (PCa) and prostatic urothelial carcinoma (PUC) for patients undergoing radical cystoprostatectomy (RCP) for bladder cancer and to ascertain what preoperative information may be useful in predicting PUC or PCa in patients who may be candidates for prostate-sparing cystectomy. Methods: Between 2001 and 2004, 235 consecutive patients underwent RCP and had whole-mount sections of the prostate. We reviewed our prospective radical cystectomy database for preoperative clinicopathological information associated with each patient. The bladder and whole-mount prostate sections were re-reviewed to determine the location and depth of the bladder tumor as well as the presence of any associated PCa and PUC. Results: We identified 113 of 235 (48%) and 77 of 235 (33%) men with PCa and PUC, respectively. Among patients with PCa, 33 (29%) had Gleason score of ≥ 7, 25 (22%) had PCa tumor volume > 0.5 cc, and 15 (13%) had extracapsular extension. On multivariable analysis, only increasing age was significantly associated with PCa (odds ratio = 1.3, p = 0.046). Of the 77 with PUC, 28 (36%) had in situ disease only, while 49 (64%) had prostatic stromal invasion. Bladder tumor location in the trigone/bladder neck (p <0.001) and bladder carcinoma in situ (p <0.001) was strongly associated with PUC in the final specimen. Overall, 158 (67%) had either PCa or PUC in the prostate. Conclusions: PCa and/or PUC is present in a majority of RCP specimens. Current preoperative staging and tumor characteristics are not adequate for determining who can safely be selected for prostate-sparing cystectomy.

KW - Bladder cancer

KW - Prostate cancer

KW - Prostate-sparing cystectomy

KW - Radical cystoprostatectomy

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