Abstract
Objectives
To assess our clinical ability to predict prostate involvement by transitional cell
carcinoma (PI-TCC) or occult prostate cancer (CAP) in patients undergoing radical
cystectomy (RCx).
Methods
We retrospectively analyzed 70 male patients undergoing RCx for TCC of the bladder
between 1995 and 2003, focusing on preoperative factors to predict PI-TCC or CAP.
Results
Of 70 RCx patients, 30 (43%) had PI-TCC (14) or CAP (16). Risk factors for PI-TCC
included carcinoma in situ, multifocal TCC, and bladder neck involvement (P <0.05 for all three analyses). All 14 patients with PI-TCC had one or more risk factors,
and none of 40 patients without these risk factors had PI-TCC (P <0.001). Risk factors for CAP included elevated prostate-specific antigen level,
abnormal results on digital rectal examination, and age more than 65 years. Of 16
patients with CAP, 14 had one or more of these risk factors (P <0.05). Sixteen of the seventy patients in this series (22.9%) had no risk factors
for PI-TCC or CAP, and none of these had prostatic involvement with either malignancy
(P <0.05).
Conclusions
Our findings suggest that a well-defined subset of patients undergoing RCx might be
at low risk for malignancy in the prostate. However, further evaluation of these risk
factors in a prospective setting will be required to substantiate these findings and
guide clinical decision making in this controversial field.
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Article info
Publication history
Accepted:
July 6,
2005
Received:
December 22,
2004
Identification
Copyright
© 2005 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
