Urothelial carcinoma involving the prostate: The association of revised tumor stage and coexistent bladder cancer with survival following radical cystectomy - Abstract

OBJECTIVE: To evaluate survival among patients with UC within the prostate in order to assess the impact of depth of tumor invasion as well as the importance of a concurrent bladder tumor.

PATIENTS AND METHODS: We identified 201 patients who underwent RC between 1980-2006 and were found to have UC involving the prostate. All specimens were re-reviewed by a genitourinary pathologist. Survival was estimated using the Kaplan-Meier method and compared with the log-rank test. Cox hazard regression models tested the association of clinicopathologic variables with outcome.

RESULTS: A total of 93 patients had pTis disease in the prostate, 43 had pT2 tumors, and 66 patients were pT4a. Median follow-up was 10.5 years. Five-year cancer-specific survival for patients with pTis, pT2, and pT4a prostate UC was 0.001). 73%, 57%, and 20% respectively (p 0.001). On multivariable analysis, higher prostate tumor stage (HR 2.09; p=0.01), positive lymph node status (HR 2.09; p=0.002), and concurrent ≥pT3 bladder cancer (HR 4.16; p=0.0006) were significantly associated with an increased risk of death from UC.

CONCLUSIONS: Among patients with prostatic UC involvement, depth of tumor invasion was significantly associated with cancer-specific mortality, validating the staging reclassification. Concurrent locally advanced bladder cancer also negatively impacted survival, suggesting the potential prognostic value of reporting a secondary tumor stage in such cases.

Written by:
Knoedler JJ, Boorjian SA, Tollefson MK, Cheville JC, Thapa P, Tarrell RF, Frank I.   Are you the author?
Department of Urology, Mayo Clinic, Rochester, Minnesota.

Reference: BJU Int. 2013 Oct 7. Epub ahead of print.
doi: 10.1111/bju.12486


PubMed Abstract
PMID: 24119219

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