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• General Considerations
  This is the second most common urologic malignancy. Ninety percent of the cases are transitional cell carcinoma. Sixty to 75% of lesions are superficial and 10-20 percent of these will progress to muscle invasive disease. The majority of muscle invasive lesions will present de novo. Intravesical therapy can decrease recurrence of superficial disease and BCG may retard the progression of disease over 5 to 10 years. Muscle invasive lesions are classically treated with cystectomy and urinary diversion. Organ sparing approaches can be employed in select cases. Advanced disease responds to cytoreductive chemotherapy, yet sustained complete responses are rare
• Incidence
  • 55,000 new cases in 2003 with 12,200 cancer related deaths
  • 4th most common cancer in men and 10th in women
  • General prevalence of 600,000 cases

References

• Albertson PC, Hanley JA, Gleason DR, Barry MJ: Competing risk analysis of men aged 55 to 74 years at diagnosis managed conservatively for clinically localized prostate cancer. JAMA 280:975-980, 1998.
• D'Amico AV, Whittington R, Malkowicz SB, et al: Biochemical outcome after radical protatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 280:969-974, 1998. Droller MJ: Bladder: Anatomical overview in surgical management of urologic disease: An anatomic approach, MJ Droller, St. Louis, Mosby Yearbook, p 575, 1992.
• Eastham JA, Scardino PT: Radical prostatectomy. In: Walsh PC, et al, eds: Campbell's Urology, 7th ed. Philadelphia, Saunders, 1998, pp 2547-2564.
• Eisenberger MA, Blumenstein BA, Crawford ED, et al: Bilateral orchiectomy with or without flutamide for metastatic prostate cancer. N Engl J Med 339:1036-1042, 1998.
• Herr HW, Schwalb DM, Zhang ZF, et al: Intravesical bacillus Calmette-Guerin therapy prevents tumor progression and death from superficial bladder cancer: Ten-year follow-up of a prospective randomized trial. J Clin Oncol 13:1404, 1995.
• Lamm DL: Complications of bacillus Calmette-Guerin immunotherapy. Urol Clin North Am 19:565, 1992.
• Malkowicz SB: Superficial bladder cancer: The role of molecular markers in the treatment of high-risk superficial disease. Semin Urol Oncol 15:169-178, 1997.
• Messing EM, Catalona W: Urothelial tumors of the urinary tract. In: Campbell's Urology 7th ed. PC Walsh, AB ED Vaughan, AJ Wein, Vol 3, Chap 77, 2327, 1998.
• Partin AW, Kattan MW, Subong EN, Walsh PC, Wojno KJ, Oesterling JE, Scardino PT, Pearson JD. Combination of prostate-specific antigen, clinical stage, and Gleason score to predict pathological stage of localized prostate cancer. A multi-institutional update. JAMA 277:1445-1451, 1997.
• Polascik TJ, Oesterling JE, Parting AW: Prostate specific antigen: A decade of discovery-What we have learned and where we are going. J Ural 162:293-306, 1999.
• Ragde H, Blasko JC, Grimm PD, et al: Interstitial iodine-125 radiation without adjuvant therapy in the treatment of clinically localized prostate carcinoma. Cancer 80:442-453, 1997.
• Spruck CH, Ohneseit PE, Gonzalez-Zulueta M, et al: Two molecular pathways to transitional cell carcinoma of the bladder. Cancer Res 54:784-788, 1994.
• Walsh PC, Partin AW, Epstein JI: Cancer control and quality of life following anatomical radical retropubic prostatectomy: Results at 10 years. J Urol 152:1831-1836, 1994.
• Zincke H, Oesterling JE, Blute ML, et al: Long-term (15 years) results after radical prostatectomy for clinically localized (stage T2c or lower) prostate cancer. J Urol 152:1850-1857, 1994.

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