You have accessJournal of UrologyBladder Cancer: Staging1 Apr 20101028 IS PROSTATE-SPARING DURING RADICAL CYSTECTOMY ADVISABLE? Venu Chalasani, Wassim Kassouf, Jonathan Izawa, Yves Fradet, Armen Aprikian, Adrian Fairey, Eric Estey, Louis Lacombe, Ricardo Rendon, David Bell, Ilias Cagiannos, Darrel Drachenberg, Jean-Baptiste Lattouf, and Joseph Chin Venu ChalasaniVenu Chalasani London, Canada More articles by this author , Wassim KassoufWassim Kassouf Montreal, Canada More articles by this author , Jonathan IzawaJonathan Izawa London, Canada More articles by this author , Yves FradetYves Fradet Quebec, Canada More articles by this author , Armen AprikianArmen Aprikian Montreal, Canada More articles by this author , Adrian FaireyAdrian Fairey Edmonton, Canada More articles by this author , Eric EsteyEric Estey Edmonton, Canada More articles by this author , Louis LacombeLouis Lacombe Quebec, Canada More articles by this author , Ricardo RendonRicardo Rendon Halifax, Canada More articles by this author , David BellDavid Bell Halifax, Canada More articles by this author , Ilias CagiannosIlias Cagiannos Ottawa, Canada More articles by this author , Darrel DrachenbergDarrel Drachenberg Winnipeg, Canada More articles by this author , Jean-Baptiste LattoufJean-Baptiste Lattouf Montreal, Canada More articles by this author , and Joseph ChinJoseph Chin London, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2063AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate-sparing cystectomy is emerging as one technique for the reduction of the morbidity associated with radical cystoprostatectomy for urothelial cancer. The drawback of techniques such as prostate-sparing cystectomy or partial cystectomy is the unknown risk of prostatic adenocarcinoma within the prostate, or urothelial cancer within the prostate. The aim of this study was to determine the prevalence of incidental prostate cancer at the time of cystoprostatectomy, and its impact on overall survival. METHODS The Canadian Bladder Cancer Network database is a pooled consortium of eight university hospital urology departments from 5 provinces of Canada. This database, consisting of 2,287 patients who underwent cystectomy between 1993-2008, was reviewed to identify all cases of incidental prostatic adenocarcinoma. All male patients (1,985) were identified to form the cohort for analysis. Statistical significance was set at 0.05. Cox regression analysis was used to identify independent predictors of overall survival and disease specific survival. RESULTS Prostate cancer was identified in 508 patients (25.6%) out of the cohort of 1,985 male patients who underwent cystectomy within this database. Pathologic stage was pT2 in 85.4%, and pT3 in 14.2%. The Gleason score was ≤6 in 73.2%, Gleason score 7 in 21.7%, and Gleason score ≥8 in 4.9%. Statistically significant variables associated with the presence of incidental prostate cancer were previous abdominal radiotherapy, age, and histology. On Cox regression analysis, the presence of prostate cancer was not an independent predictor of overall or disease specific survival. There was no statistically significant difference in overall or disease specific survival between those patients with prostate cancer versus those patients without prostate cancer. CONCLUSIONS The prevalence of incidental prostate cancer was 25.6% in this large multi-institutional cohort of 1,985 male cystectomy patients. Of these 508 patients with incidental prostate cancer, 26% had Gleason scores ≥7, and 14% had extraprostatic extension of the prostatic adenocarcinoma. These figures underscore the need for careful pre-operative counseling and appropriate screening of men being considered for prostate-sparing cystectomy. Age Prostate Cancer No Prostate Cancer <40 2(9.5%) 19(90.5%) 40-49 8(6.8%) 110(93.2%) 50-59 67(19.3%) 281(80.7%) 60-69 144(24.4%) 447(75.6%) 70-79 230(31.6%) 499(68.4%) 80-89 49(31.8%) 105(68.2%) >89 3(50%) 3(50%) © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e400 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Venu Chalasani London, Canada More articles by this author Wassim Kassouf Montreal, Canada More articles by this author Jonathan Izawa London, Canada More articles by this author Yves Fradet Quebec, Canada More articles by this author Armen Aprikian Montreal, Canada More articles by this author Adrian Fairey Edmonton, Canada More articles by this author Eric Estey Edmonton, Canada More articles by this author Louis Lacombe Quebec, Canada More articles by this author Ricardo Rendon Halifax, Canada More articles by this author David Bell Halifax, Canada More articles by this author Ilias Cagiannos Ottawa, Canada More articles by this author Darrel Drachenberg Winnipeg, Canada More articles by this author Jean-Baptiste Lattouf Montreal, Canada More articles by this author Joseph Chin London, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...