Incidental Adenocarcinoma Of Prostate Research Articles

Frequency of Incidental Prostate Adenocarcinoma Detection in Patients with Radical Cystoprostatectomy for Bladder Urothelial Cancer and Research into the Need for PSA Monitoring for Local-systemic Recurrence

Frequency of Incidental Prostate Adenocarcinoma Detection in Patients with Radical Cystoprostatectomy for Bladder Urothelial Cancer and Research into the Need for PSA Monitoring for Local-systemic Recurrence

Incidental Prostate Adenocarcinoma in Prostate Transurethral Resections: Our Eight Year Experience

Incidental Prostate Adenocarcinoma in Prostate Transurethral Resections: Our Eight Year Experience

MP06-16 PREVALENCE AND CLONALITY OF SYNCHRONOUS PRIMARY CARCINOMAS IN THE BLADDER AND PROSTATE

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation I1 Apr 2018MP06-16 PREVALENCE AND CLONALITY OF SYNCHRONOUS PRIMARY CARCINOMAS IN THE BLADDER AND PROSTATE Ruiyun Zhang, Ying Jing, Wei Xue, Yiran Huang, Guanglei Zhuang, and Haige Chen Ruiyun ZhangRuiyun Zhang More articles by this author , Ying JingYing Jing More articles by this author , Wei XueWei Xue More articles by this author , Yiran HuangYiran Huang More articles by this author , Guanglei ZhuangGuanglei Zhuang More articles by this author , and Haige ChenHaige Chen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.208AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Incidental prostate adenocarcinoma (IPCa) has been frequently discovered during postoperative histopathological evaluation of radical cystoprostatectomy specimens in patients with muscle-invasive bladder cancer (MIBCa). However, a conclusive investigation is currently lacking with regard to the clinical significance of IPCa and the clonal relatedness of IPCa and MIBCa. METHODS Here, we performed a large retrospective single-center review of 919 MIBCa cases and an additional meta-analysis containing a total of 19,868 individuals who underwent radical cystectomy for bladder cancer. As a complementary approach, we sampled thirteen cases of synchronous BCa and IPCa (RJBC1-13) and performed whole-exome sequencing on matched bladder and prostate tumors with adjacent normal bladder tissues as controls. Furthermore, RESULTS IPCa was detected in 67 of 919 MIBCa patients (7.3%), which was significantly associated with greater age. A lower prevalence was observed in Asian populations (19.387 ± 3.277%) as compared to non-Asian countries (31.765 ± 2.284%), presumably due to different rates of prostate cancer occurrence. Whole-exome sequencing on matched MIBCa and IPCa samples unambiguously revealed independent clonal origins of the synchronous tumors. MIBCa and IPCa lesions from each patient displayed distinctive genomic abnormalities and unrelated mutational signatures of single nucleotide variations, indicating disparate mutational processes underlying bladder and prostate oncogenesis. CONCLUSIONS These findings provide important insights into the incidental nature of prostate adenocarcinoma in patients with bladder cancer and suggest that the two concurrent diseases can be managed separately. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e58 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Ruiyun Zhang More articles by this author Ying Jing More articles by this author Wei Xue More articles by this author Yiran Huang More articles by this author Guanglei Zhuang More articles by this author Haige Chen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Prevalence and clonality of synchronous primary carcinomas in the bladder and prostate

Incidental prostate adenocarcinoma (IPCa) has been frequently discovered during postoperative histopathological evaluation of radical cystoprostatectomy specimens in patients with bladder cancer (BCa). However, there is currently no conclusive study addressing the clinical significance of IPCa and the clonal relatedness of IPCa and BCa. Here, we performed a retrospective single-center review of 919 BCa cases and an additional meta-analysis including a total of 19 868 individuals who underwent radical cystectomy for bladder cancer. IPCa, mostly clinically insignificant, was detected in 67 of 919 BCa patients (7.3%) and was significantly associated with greater age. In the meta-analysis, a lower prevalence was observed in Asian than in non-Asian countries (19% versus 32%), presumably due to their different rates of prostate cancer occurrence. Whole-exome sequencing on matched BCa and IPCa samples unambiguously revealed independent clonal origins of the synchronous tumors. BCa and IPCa lesions from each patient displayed distinctive genomic abnormalities and largely unrelated mutational signatures of single nucleotide variations, indicating disparate mutational processes underlying bladder and prostate oncogenesis. These findings provide important insights into the incidental nature of prostate adenocarcinoma in patients with bladder cancer, and suggest that the two concurrent diseases can be managed separately. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

MP54-19 IMPACT OF PROSTATE INVOLVEMENT ON OUTCOMES IN PATIENTS TREATED WITH RADICAL CYSTOPROSTATECTOMY FOR BLADDER CANCER

You have accessJournal of UrologyBladder Cancer: Invasive IV1 Apr 2017MP54-19 IMPACT OF PROSTATE INVOLVEMENT ON OUTCOMES IN PATIENTS TREATED WITH RADICAL CYSTOPROSTATECTOMY FOR BLADDER CANCER Marco Moschini, Andrea Gallina, Giusy Burgio, Paolo Dell'Oglio, Emanuele Zaffuto, Agostino Mattei, Rocco Damiano, Shahrokh Shariat, Vincenzo Mirone, Andrea Salonia, Alberto Briganti, Francesco Montorsi, and Renzo Colombo Marco MoschiniMarco Moschini More articles by this author , Andrea GallinaAndrea Gallina More articles by this author , Giusy BurgioGiusy Burgio More articles by this author , Paolo Dell'OglioPaolo Dell'Oglio More articles by this author , Emanuele ZaffutoEmanuele Zaffuto More articles by this author , Agostino MatteiAgostino Mattei More articles by this author , Rocco DamianoRocco Damiano More articles by this author , Shahrokh ShariatShahrokh Shariat More articles by this author , Vincenzo MironeVincenzo Mirone More articles by this author , Andrea SaloniaAndrea Salonia More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Renzo ColomboRenzo Colombo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1691AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The impact of the different types of prostate involvement by urothelial carcinoma (PUC) or prostate adenocarcinoma (PCa) at the time of radical cystoprostatectomy (RCP) has not been fully investigated. METHODS Data from 893 male patients treated with RCP and pelvic lymph node dissection at a tertiary referral center for nonmetastatic bladder cancer between 1992 and 2012 were assessed. Significant PCa was defined as extracapsular disease and/or Gleason Score = 7. Prostatic urothelial carcinoma (PUC) was stratified as stromal versus urethral/duct involvements. Multivariable Cox regression analyses were built to test the impact of the presence of incidental PCa and PUC on outcomes. RESULTS PCa was present in 319 (35.7%) patients, of which 45 (14.1%) had significant disease. While, the proportion of significant PCa did not change significantly (p=0.8), the rate of indolent PCa increased from 17.1%, to 29.4% to 37.9%, respectively (p<0.001). PUC was identify in 181 patients (20%): 75 (41.1%) with urethral/duct involvement and 106 (58.6%) with stromal. Within a median follow-up of 72 months, stromal PUC, but not the other forms of PUC or PCa, was associated with disease recurrence and cancer-specific mortality. In multivariable analyses adjusted for the effects of standard features, stromal PUC remained associated with recurrence (Hazard Ratio [HR]:2.01, p=0.03) cancer-specific mortality (HR: 1.65, p=0.01) and overall mortality (HR: 1.45, p=0.03). CONCLUSIONS PCa involvement does not affect outcomes in patients treated with RCP for bladder cancer. Conversely, prostatic stromal invasion with urothelial carcinoma confers a poor survival confirming its aggressiveness. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e729 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Marco Moschini More articles by this author Andrea Gallina More articles by this author Giusy Burgio More articles by this author Paolo Dell'Oglio More articles by this author Emanuele Zaffuto More articles by this author Agostino Mattei More articles by this author Rocco Damiano More articles by this author Shahrokh Shariat More articles by this author Vincenzo Mirone More articles by this author Andrea Salonia More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Renzo Colombo More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

The prognostic role of ERG immunopositivity in prostatic acinar adenocarcinoma: a study including 454 cases and review of the literature

TMPRSS2/ERG fusion is among the most frequent genetic anomalies in prostate adenocarcinomas. Although positive immunostaining for ERG has been shown to tightly correlate with ERG fusion status, the clinical and prognostic significance of a positive ERG stain remains undetermined. The significance of ERG immunostaining in 454 consecutive prostate adenocarcinomas from radical prostatectomies (RPs) using tissue microarrays, herein, is evaluated. A separate set of 59 cases of incidental prostate adenocarcinoma detected on transurethral resection of prostate with a Gleason score of 6 was also included. ERG translocation was significantly more common in peripheral zone cancer in comparison with cancer of the transitional zone (33% in RP versus 5% in transurethral resection of prostate specimens). In the RP cohort, although ERG positivity was significantly associated with younger age at presentation and lower prostate-specific antigen values, it showed no association with Gleason score or with pathologic stage. In multivariate analysis, biochemical recurrence was only associated with the final RP Gleason score and elevated prostate-specific antigen levels and was unrelated to neither ERG positivity or to its staining intensity. In our hands, ERG positivity was unrelated to either aggressive local tumor characteristics or a worse outcome. Our results, as well as an extensive review of the related literature showing conflicting findings, seem to indicate that ERG immunopositivity cannot be considered as an important prognostic factor in prostate cancer.

Incidental prostate cancer in patients with radical cystectomy for bladder cancer.

225 Background: Radical cystectomy is the gold standard surgical treatment for invasive bladder cancer. Prostate adenocarcinoma is often found incidentally in the cystoprostatectomy specimen. The clinical significance of this type of cancer has not been well characterized. We reviewed the cohort of male patients with bladder cancer who underwent radical cystectomy and found to have incidental prostate adenocarcinoma. Methods: 1,964 patients with primary transitional cell carcinoma of bladder underwent radical cystectomy between 1971 and 2008 with a median follow-up of 12.1 yrs (0.1-36) at USC. 1553 of them were male (79%) and 559 (36%) had incidental pathologic prostate adenocarcinoma (PC-group). Prostate and bladder cancer characteristics, recurrence and overall survival (OS) in the cohort of PC-group are reviewed. Results: Median age in the PC-group was 69 yo (35-92). The incidental PC was organ confined (OC) in 527 patients (94%). 32 (6%) had non-OC prostate cancer, treated by adjuvant radiation (5), hormone ablation (3) with a median follow-up of 3.9 yrs (0.1-16). Median pre-op PSA was 1.66 (0.01-83) in PC-group and 1.31 (0.01-33.2) in non-PC group. Gleason score was ≤ 6 in 458 (82%), 7 in 78 (14%) and ≥ 8 in 12 (2%) cases. Reviewing bladder cancer in the PC vs. non-PC group, 84 and 83% had high-grade cancer, 63 and 58% had associated CIS, 41 and 36% had multifocal disease and 29 and 27% had LVI respectively (P &gt; 0.05). Incidental PC did not have significant effect on recurrence (P=0.3) and OS (P=0.4) after cystectomy for bladder urothelial cancer. No patient died of PC. 5-year OS rate was 60 ± 2% in both PC and non-PC groups. 10-year OS rate was also comparable at 42 ± 2% in PC and 44 ± 2% in non-PC-group. Conclusions: Incidental prostate adenocarcinoma is reported in more than one third of patients who undergo radical cystectomy for bladder cancer. It is organ confined in most of the cases and has no correlation with bladder cancer stage. Outcome of patients with incidental prostate adenocarcinoma at the time of radical cystectomy relies exclusively on the bladder cancer.

Actitud expectante en el adenocarcinoma incidental de próstata

Objetive To describe the outcome of patients diagnosed of incidental prostate adenocarcinoma managed by watchful waiting. Material and methods We included patients with PSA<4 ng/mL or higher with previous negative biopsy, who underwent surgery for BPH being diagnosed of incidental prostate adenocarcinoma. We performed a descriptive and retrospective study in patients with this diagnosis between 1992 and 2007. Salvage curative treatment was offered to those patients who progressed. Statistical analysis was performed using SPSS program. Progression variables were: age, preoperative and postoperative PSA, stage, Gleason score, prostate volume, initial treatment, PSA evolution and salvage treatment if necessary. Results 47 patients were diagnosed of incidental prostatic adenocarcinoma, finding an incidence of 4.25%. The medium follo up was 37 months. Of the patients who opted for watchful waiting, 72,5% remain on it. 11 patients progressed. Postoperative PSA and Gleason score showed up as prognostic variables of progression in T1a stage and postsurgery PSA did so in T1b patients. Conclusion Watchful waiting is a useful option in patients with incidental prostate adenocarcinoma and favourable prognostic criteria. Postoperative PSA and Gleason score can predict progression in T1a stage and postoperative PSA in T1b stage.

Watchful waiting in incidental adenocarcinoma of the prostate

ObjetiveTo describe the outcome of patients diagnosed of incidental prostate adenocarcinoma managed by watchful waiting. Material and methodsWe included patients with PSA<4ng/mL or higher with previous negative biopsy, who underwent surgery for BPH being diagnosed of incidental prostate adenocarcinoma. We performed a descriptive and retrospective study in patients with this diagnosis between 1992 and 2007. Salvage curative treatment was offered to those patients who progressed. Statistical analysis was performed using the SPSS program. Progression variables were: age, preoperative and postoperative PSA, stage, Gleason score, prostate volume, initial treatment, PSA evolution and salvage treatment if necessary. Results47 patients were diagnosed of incidental prostatic adenocarcinoma, finding an incidence of 4.25%. The mean follow up was 37 months. Of the patients who opted for watchful waiting, 72.5% remain on it. 11 patients progressed. Postoperative PSA and Gleason score showed up as prognostic variables of progression in T1a stage and postsurgery PSA did so in T1b patients. ConclusionWatchful waiting is a useful option in patients with incidental prostate adenocarcinoma and favourable prognostic criteria. Postoperative PSA and Gleason score can predict progression in T1a stage and postoperative PSA in T1b stage.

Prediction of Prostatic Involvement by Urothelial Carcinoma in Radical Cystoprostatectomy for Bladder Cancer

To ascertain which variables of bladder urothelial carcinoma (UC) might be useful in predicting either UC involving the prostate (UCP) or incidental prostate adenocarcinoma in radical cystoprostatectomy specimens. The bladder and whole-mount prostate sections of 248 radical cystoprostatectomy specimens were reviewed. Stepwise discriminant analysis was used to predict UCP or incidental prostate adenocarcinoma. UCP was present in 94 patients (37.9%). UC originated from the prostatic urethra and periurethral ducts in 78 (31.45%), and isolated direct extension of UC from the bladder was present in 16 patients (6.45%). The periurethral ducts coexisted with direct extension of bladder UC in 11 patients (4.4%). Prostate adenocarcinoma was identified in 123 patients (49.6%). Carcinoma in situ and high-grade urothelial papillary carcinoma were seen in 8 (3.2%) and 5 (2.0%) patients, respectively. In 57 (23%), 64 (25.8%), and 87 (35.1%) patients, UC had invaded the subepithelial connective tissue, muscularis propria, and perivesical tissue, respectively. UC was multifocal in 53 patients (21.4%). The tumor was in the trigone and bladder neck in 160 patients (64.5%). Of the 248 patients, 98 (39.5%) had a history of recurrence. Stepwise discriminant analysis selected 3 variables of bladder UC (previous recurrence and location and number of foci) and correctly predicted the group in 72.2% of patients without and with UCP. Discriminant analysis selected 2 variables of bladder UC (focality and previous recurrence) and correctly predicted the group in 57.7% of patients without and with prostate adenocarcinoma. Our approach can identify bladder UC variables that could guide urologists in the selection of the most appropriate surgical procedure.

Incidental prostate cancer in patients undergoing radical cystoprostatectomy for bladder cancer.

The objective of this work is to verify the incidence of incidental prostate adenocarcinoma in patients who underwent radical cystoprostatectomy for invasive bladder carcinoma. We have retrospectively reviewed patients who underwent radical cystoprostatectomy for infiltrative bladder tumors in period between 2003 and 2007 year, 94 men with bladder cancer underwent radical cystoprostatectomy at Urology Clinic-University of Sarajevo Clinics Centre. Mean age of patients was 67 years, with age limits ranging between 48 and 79 years. Pathohistological evaluation was used for all specimens from RCP. We found that 9,57% of cystoprostatectomy specimens in patients with bladder cancer also contained incidental prostate cancer. This result was much lower than overall mean frequency of incidentally detected prostate cancer in other series of cystoprostatectomy cases (range, 23%-68%). In conclusion we recommended digital rectal examination (DRE) and prostate-specific antigen (PSA) test as part of the bladder cancer work up and complete removal of the prostate at cystoprostatectomy to prevent residual prostate cancer.

Oncological Evaluation of Prostate Sparing Cystectomy: The Montsouris Long-Term Results

Prostate sparing cystectomy provides an alternative therapeutic option in highly selected patients with invasive bladder cancer who wish to avoid the significant functional side effects of traditional surgery. Concern exists regarding the oncological safety of this technique especially with regard to the presence of prostatic urothelial cancer and incidental prostate adenocarcinoma. We present the long-term oncological outcomes of a large series of patients treated at a single institution. Between October 1992 and June 2004 a total of 117 patients were selected for prostate sparing cystectomy after meeting the inclusion criteria. Nine patients underwent radical cystoprostatectomy after prostate urothelial carcinoma was diagnosed intraoperatively. Long-term oncological results (2 years minimum followup [mean 55 months]) are presented here for the remaining patients. The rate of local and distant recurrence was 4.7% and 34%, respectively, at 20 months. Overall survival at 5 years in our study was 67%, and 5-year disease-free survival rates were 77% for pT2 N0 or less, 44% for pT3 N0 or greater and 22% for pN+ disease. Of 6 patients found to have prostate adenocarcinoma in transurethral prostate resection specimens 1 was treated with high intensity focused ultrasound and 5 were followed with active surveillance, 2 of whom later died of bladder cancer. We report oncological data on the largest prospective cohort of patients, with the longest followup, treated by prostate sparing cystectomy to date. Outcomes are comparable with the largest published series of cystoprosatectomies. With appropriate screening the risk of a clinically significant prostate cancer appears to be low. For certain selected patients this technique represents a valuable additional option for treatment.

Investigate the Treatment of Incidental Adenocarcinoma of Prostate (Report of 28 Cases)

目的 探讨偶发前列腺癌的治疗.方法对28例偶发前列腺癌病例进行临床总结,病理诊断后28例均施行了去势手术.结果26例获得随访,A1期18例,A2期8例,随访时间10个月至8年,存活18例,最长时间为8年.结论对偶发前列腺癌去势手术可降低进展率,A1期可无需行根治性治疗,术后随访要监测PSA。

Incidental prostate adenocarcinoma in a thirty-year-old native american

We report a case of prostatic adenocarcinoma in a thirty-year-old Native American. The tumor was an incidental autopsy finding. We speculate on the biological and clinical significance of prostate tumors in young males.