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Abstract：
BACKGROUND: The impact of incidental prostate cancer (IPC) on oncological outcomes after radical cystoprostatectomy (RCP) specimens from patients with bladder cancer (BC) remains controversial. This relationship has not been well elucidated in Asian countries, where the incidence of prostate cancer has recently shown dramatic increases.
OBJECTIVE: This study retrospectively compared pathological features and oncological outcomes between BC patients with and without IPC in the RCP specimens.
METHODS: This study included 142 men who underwent RCP for BC. Men who were previously diagnosed with prostate cancer were excluded. Each prostate gland and seminal vesicle was processed as whole mounts and 4-mm close-step sectioning was performed. A single genitourinary pathologist diagnosed IPC. The pathological features and oncological outcomes such as overall survival (OS), bladder cancer-specific survival (BCSS), and progression-free survival (PFS) were compared between patients with IPC (IPC+group, n = 45) and without IPC (IPC- group, n = 97). P values less than 0.05 considered to indicate statistical significance for patients\' characteristics. Because of multi-primary endpoint, P values less than 0.0167 was considered statistical significance for oncological outcomes.
RESULTS: We detected IPC in 45 RCP specimens (31.6%). Patients in the IPC- group were significantly younger at surgery than those in the IPC+group (P < 0.001). The pathological features of the RCP specimens did not differ significantly. In multivariable analyses, presence of IPC was significantly associated with worse OS (P = 0.005), but not with either BCSS or PFS (P = 0.038 and 0.326, respectively). In Kaplan-Meier analyses, OS tended to be longer in the IPC- group than that in the IPC+group (NR vs 65 months, P = 0.0017).
CONCLUSIONS: Our results suggested significantly better OS in patients without IPC than that in those with IPC.
OBJECTIVE: This study retrospectively compared pathological features and oncological outcomes between BC patients with and without IPC in the RCP specimens.
METHODS: This study included 142 men who underwent RCP for BC. Men who were previously diagnosed with prostate cancer were excluded. Each prostate gland and seminal vesicle was processed as whole mounts and 4-mm close-step sectioning was performed. A single genitourinary pathologist diagnosed IPC. The pathological features and oncological outcomes such as overall survival (OS), bladder cancer-specific survival (BCSS), and progression-free survival (PFS) were compared between patients with IPC (IPC+group, n = 45) and without IPC (IPC- group, n = 97). P values less than 0.05 considered to indicate statistical significance for patients\' characteristics. Because of multi-primary endpoint, P values less than 0.0167 was considered statistical significance for oncological outcomes.
RESULTS: We detected IPC in 45 RCP specimens (31.6%). Patients in the IPC- group were significantly younger at surgery than those in the IPC+group (P < 0.001). The pathological features of the RCP specimens did not differ significantly. In multivariable analyses, presence of IPC was significantly associated with worse OS (P = 0.005), but not with either BCSS or PFS (P = 0.038 and 0.326, respectively). In Kaplan-Meier analyses, OS tended to be longer in the IPC- group than that in the IPC+group (NR vs 65 months, P = 0.0017).
CONCLUSIONS: Our results suggested significantly better OS in patients without IPC than that in those with IPC.
摘要：
背景：膀胱癌（BC）患者根治性膀胱前列腺切除术（RCP）后，偶发前列腺癌（IPC）对肿瘤预后的影响仍存在争议。这种关系在亚洲国家还没有得到很好的阐明,前列腺癌的发病率最近急剧增加。
目的：本研究回顾性比较了RCP标本中伴IPC和不伴IPC的BC患者的病理特征和肿瘤结局。
方法：本研究包括142例接受BCRCP治疗的男性。先前被诊断为前列腺癌的男性被排除在外。将每个前列腺和精囊作为整体进行处理，并进行4毫米近距离切片。一名泌尿生殖系统病理学家诊断为IPC。病理特征和肿瘤结果，如总生存期（OS），膀胱癌特异性生存率（BCSS），比较IPC患者的无进展生存期（PFS）（IPC+组，n=45)且无IPC(IPC-组,n=97）。P值小于0.05被认为表明患者特征有统计学意义。由于多主要端点，P值小于0.0167被认为是肿瘤学结果的统计学意义。
结果：我们在45个RCP样本中检测到IPC（31.6％）。IPC-组患者在手术时明显小于IPC+组(P<0.001)。RCP标本的病理特点无明显差别。在多变量分析中，IPC的存在与OS恶化显著相关(P=0.005)，但没有BCSS或PFS（分别为P=0.038和0.326）。在Kaplan-Meier分析中，IPC组的OS倾向于长于IPC+组(NRvs65个月，P=0.0017)。
结论：我们的结果表明，没有IPC的患者的OS明显优于IPC的患者。
目的：本研究回顾性比较了RCP标本中伴IPC和不伴IPC的BC患者的病理特征和肿瘤结局。
方法：本研究包括142例接受BCRCP治疗的男性。先前被诊断为前列腺癌的男性被排除在外。将每个前列腺和精囊作为整体进行处理，并进行4毫米近距离切片。一名泌尿生殖系统病理学家诊断为IPC。病理特征和肿瘤结果，如总生存期（OS），膀胱癌特异性生存率（BCSS），比较IPC患者的无进展生存期（PFS）（IPC+组，n=45)且无IPC(IPC-组,n=97）。P值小于0.05被认为表明患者特征有统计学意义。由于多主要端点，P值小于0.0167被认为是肿瘤学结果的统计学意义。
结果：我们在45个RCP样本中检测到IPC（31.6％）。IPC-组患者在手术时明显小于IPC+组(P<0.001)。RCP标本的病理特点无明显差别。在多变量分析中，IPC的存在与OS恶化显著相关(P=0.005)，但没有BCSS或PFS（分别为P=0.038和0.326）。在Kaplan-Meier分析中，IPC组的OS倾向于长于IPC+组(NRvs65个月，P=0.0017)。
结论：我们的结果表明，没有IPC的患者的OS明显优于IPC的患者。
