Radikal sistoprostatektomi yapılan hastalarda prostat kanseri insidansı ve klinik önemi

Aim: Incidental prostate adenocarcinomas which are detected in radical cystoprostatectomy (RCP) specimens are generally localized, well differentiated and have no clinical importance. In this study, we aimed to determine the rate of incidental prostate adenocarcinoma in patients underwent RCP and assess its effect on survival of the patients. Materials and Methods: The patients who underwent RCP for urothelial bladder cancer between September 2007 and March 2014 were analyzed retrospectively. Deep muscle invasion of urothelial carcinoma or high grade transitional epithelial cell carcinoma that could not be controlled by transurethral resection were the indications for surgery. Standard RCP and bilaterally expanded pelvic lymphadenectomy were performed in all patients. All samples of the cystoprostatectomy specimen were examined; Gleason degree of tumor, concurrent prostatic intraepithelial neoplasia, extracapsular extension, invasion of seminal vesicle, and metastasis of lymph nodes were evaluated. Results: Incidental prostate adenocarcinoma was diagnosed in 26 of 126 patients (20.6%) who underwent RCP for bladder urothelial carcinoma. The stages of prostate cancer were pT2a in 16 patients (61.5%), pT2c in 8 patients (30.7%), and T3b in 2 patients (7.6%). Gleason score was detected as lower than 6 in 18 patients, 7 (4+3) in 6 patients, and 9 (5+4) in 2 patients. Conclusion: All prostate tissue should be resected with no residual prostate tissue left in patients who underwent RCP for bladder cancer. The high coincidence of bladder and prostate cancers should be kept in mind, careful and detailed pathological examinations are needed.