Incidental prostate cancer in Asian men: High prevalence of incidental prostatic adenocarcinoma in Chinese patients undergoing radical cystoprostatectomy for treatment of bladder cancer and selection of candidates for prostate-sparing cystectomy

Xinyu Yang, M. Francesca Monn, Libo Liu, Yuli Liu, Jinwei Su, Tianjing Lyu, Yanqing Gong, Lisha Wang, Darrell Davidson, Liang Cheng

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Abstract

Background Previous studies report a low prevalence of incidental prostate cancer in Chinese patients (3-7%). We evaluated incidental prostatic adenocarcinoma (PCa) and urothelial carcinoma (UCa) involvement of the prostate in cystoprostatectomy specimens. Methods We analyzed 340 cystoprostatectomy specimens from patients who underwent radical cystoprostatectomy for the treatment of bladder cancer in China from 2004 to 2014. None of the patients had known prostate cancer prior to cystoprostatectomy. Results Overall, 180 (53%) patients had either PCa or UCa in the prostate. We found that 95 (28%) had PCa and 115 (34%) had UCa involvement of prostate. The rate of incidental prostate cancer was 21% and 31%, respectively, from two study periods (2004-2008 and 2009-2014). Among the 95 patients with PCa, 19 (20%) had Gleason score of ≥7, nine (10%) had PCa tumor volume >0.5 cc, and eight (8.4%) had extracapsular extension. Of the 115 with prostatic UCa, 61 had prostatic urethra and/or periurethral prostatic duct involvement only, while 54 had prostatic stromal invasion. Age (odds ratio [OR] = 1.04, P = 0.001), increasing stage of bladder tumor (OR = 1.28, P = 0.005), multifocal tumors of bladder (OR = 3.22, P <0.001), carcinoma in situ (CIS) in the bladder (OR = 5.52, P <0.001), and bladder neck involvement (OR = 6.12, P <0.001) were strongly associated with prostatic UCa. Conclusions The rate of incidental PCa in cystoprostatectomy specimens in China has increased over the last decade. Patients with advanced age, elevated serum PSA level, advanced bladder tumor stage, multifocal bladder tumors, CIS in the bladder, and tumor location at the bladder neck should be excluded as candidates for prostate-sparing cystectomy. Prostate 75:845-854, 2015.

Original languageEnglish (US)
Pages (from-to)845-854
Number of pages10
JournalProstate
Volume75
Issue number8
DOIs
StatePublished - Jun 1 2015

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Cystectomy
Urinary Bladder Neoplasms
Prostate
Prostatic Neoplasms
Adenocarcinoma
Odds Ratio
Carcinoma
Urinary Bladder
Carcinoma in Situ
China
Therapeutics
Neoplasm Grading
Urethra
Tumor Burden
Serum

Keywords

  • Asian Chinese men
  • bladder cancer
  • clinically insignificant
  • cystoprostatectomy
  • incidental prostate cancer
  • prostate

ASJC Scopus subject areas

  • Urology
  • Oncology
  • Medicine(all)

Cite this

Incidental prostate cancer in Asian men : High prevalence of incidental prostatic adenocarcinoma in Chinese patients undergoing radical cystoprostatectomy for treatment of bladder cancer and selection of candidates for prostate-sparing cystectomy. / Yang, Xinyu; Monn, M. Francesca; Liu, Libo; Liu, Yuli; Su, Jinwei; Lyu, Tianjing; Gong, Yanqing; Wang, Lisha; Davidson, Darrell; Cheng, Liang.

In: Prostate, Vol. 75, No. 8, 01.06.2015, p. 845-854.

Research output: Contribution to journalArticle

Yang, Xinyu ; Monn, M. Francesca ; Liu, Libo ; Liu, Yuli ; Su, Jinwei ; Lyu, Tianjing ; Gong, Yanqing ; Wang, Lisha ; Davidson, Darrell ; Cheng, Liang. / Incidental prostate cancer in Asian men : High prevalence of incidental prostatic adenocarcinoma in Chinese patients undergoing radical cystoprostatectomy for treatment of bladder cancer and selection of candidates for prostate-sparing cystectomy. In: Prostate. 2015 ; Vol. 75, No. 8. pp. 845-854.
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title = "Incidental prostate cancer in Asian men: High prevalence of incidental prostatic adenocarcinoma in Chinese patients undergoing radical cystoprostatectomy for treatment of bladder cancer and selection of candidates for prostate-sparing cystectomy",
abstract = "Background Previous studies report a low prevalence of incidental prostate cancer in Chinese patients (3-7{\%}). We evaluated incidental prostatic adenocarcinoma (PCa) and urothelial carcinoma (UCa) involvement of the prostate in cystoprostatectomy specimens. Methods We analyzed 340 cystoprostatectomy specimens from patients who underwent radical cystoprostatectomy for the treatment of bladder cancer in China from 2004 to 2014. None of the patients had known prostate cancer prior to cystoprostatectomy. Results Overall, 180 (53{\%}) patients had either PCa or UCa in the prostate. We found that 95 (28{\%}) had PCa and 115 (34{\%}) had UCa involvement of prostate. The rate of incidental prostate cancer was 21{\%} and 31{\%}, respectively, from two study periods (2004-2008 and 2009-2014). Among the 95 patients with PCa, 19 (20{\%}) had Gleason score of ≥7, nine (10{\%}) had PCa tumor volume >0.5 cc, and eight (8.4{\%}) had extracapsular extension. Of the 115 with prostatic UCa, 61 had prostatic urethra and/or periurethral prostatic duct involvement only, while 54 had prostatic stromal invasion. Age (odds ratio [OR] = 1.04, P = 0.001), increasing stage of bladder tumor (OR = 1.28, P = 0.005), multifocal tumors of bladder (OR = 3.22, P <0.001), carcinoma in situ (CIS) in the bladder (OR = 5.52, P <0.001), and bladder neck involvement (OR = 6.12, P <0.001) were strongly associated with prostatic UCa. Conclusions The rate of incidental PCa in cystoprostatectomy specimens in China has increased over the last decade. Patients with advanced age, elevated serum PSA level, advanced bladder tumor stage, multifocal bladder tumors, CIS in the bladder, and tumor location at the bladder neck should be excluded as candidates for prostate-sparing cystectomy. Prostate 75:845-854, 2015.",
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author = "Xinyu Yang and Monn, {M. Francesca} and Libo Liu and Yuli Liu and Jinwei Su and Tianjing Lyu and Yanqing Gong and Lisha Wang and Darrell Davidson and Liang Cheng",
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TY - JOUR

T1 - Incidental prostate cancer in Asian men

T2 - High prevalence of incidental prostatic adenocarcinoma in Chinese patients undergoing radical cystoprostatectomy for treatment of bladder cancer and selection of candidates for prostate-sparing cystectomy

AU - Yang, Xinyu

AU - Monn, M. Francesca

AU - Liu, Libo

AU - Liu, Yuli

AU - Su, Jinwei

AU - Lyu, Tianjing

AU - Gong, Yanqing

AU - Wang, Lisha

AU - Davidson, Darrell

AU - Cheng, Liang

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Background Previous studies report a low prevalence of incidental prostate cancer in Chinese patients (3-7%). We evaluated incidental prostatic adenocarcinoma (PCa) and urothelial carcinoma (UCa) involvement of the prostate in cystoprostatectomy specimens. Methods We analyzed 340 cystoprostatectomy specimens from patients who underwent radical cystoprostatectomy for the treatment of bladder cancer in China from 2004 to 2014. None of the patients had known prostate cancer prior to cystoprostatectomy. Results Overall, 180 (53%) patients had either PCa or UCa in the prostate. We found that 95 (28%) had PCa and 115 (34%) had UCa involvement of prostate. The rate of incidental prostate cancer was 21% and 31%, respectively, from two study periods (2004-2008 and 2009-2014). Among the 95 patients with PCa, 19 (20%) had Gleason score of ≥7, nine (10%) had PCa tumor volume >0.5 cc, and eight (8.4%) had extracapsular extension. Of the 115 with prostatic UCa, 61 had prostatic urethra and/or periurethral prostatic duct involvement only, while 54 had prostatic stromal invasion. Age (odds ratio [OR] = 1.04, P = 0.001), increasing stage of bladder tumor (OR = 1.28, P = 0.005), multifocal tumors of bladder (OR = 3.22, P <0.001), carcinoma in situ (CIS) in the bladder (OR = 5.52, P <0.001), and bladder neck involvement (OR = 6.12, P <0.001) were strongly associated with prostatic UCa. Conclusions The rate of incidental PCa in cystoprostatectomy specimens in China has increased over the last decade. Patients with advanced age, elevated serum PSA level, advanced bladder tumor stage, multifocal bladder tumors, CIS in the bladder, and tumor location at the bladder neck should be excluded as candidates for prostate-sparing cystectomy. Prostate 75:845-854, 2015.

AB - Background Previous studies report a low prevalence of incidental prostate cancer in Chinese patients (3-7%). We evaluated incidental prostatic adenocarcinoma (PCa) and urothelial carcinoma (UCa) involvement of the prostate in cystoprostatectomy specimens. Methods We analyzed 340 cystoprostatectomy specimens from patients who underwent radical cystoprostatectomy for the treatment of bladder cancer in China from 2004 to 2014. None of the patients had known prostate cancer prior to cystoprostatectomy. Results Overall, 180 (53%) patients had either PCa or UCa in the prostate. We found that 95 (28%) had PCa and 115 (34%) had UCa involvement of prostate. The rate of incidental prostate cancer was 21% and 31%, respectively, from two study periods (2004-2008 and 2009-2014). Among the 95 patients with PCa, 19 (20%) had Gleason score of ≥7, nine (10%) had PCa tumor volume >0.5 cc, and eight (8.4%) had extracapsular extension. Of the 115 with prostatic UCa, 61 had prostatic urethra and/or periurethral prostatic duct involvement only, while 54 had prostatic stromal invasion. Age (odds ratio [OR] = 1.04, P = 0.001), increasing stage of bladder tumor (OR = 1.28, P = 0.005), multifocal tumors of bladder (OR = 3.22, P <0.001), carcinoma in situ (CIS) in the bladder (OR = 5.52, P <0.001), and bladder neck involvement (OR = 6.12, P <0.001) were strongly associated with prostatic UCa. Conclusions The rate of incidental PCa in cystoprostatectomy specimens in China has increased over the last decade. Patients with advanced age, elevated serum PSA level, advanced bladder tumor stage, multifocal bladder tumors, CIS in the bladder, and tumor location at the bladder neck should be excluded as candidates for prostate-sparing cystectomy. Prostate 75:845-854, 2015.

KW - Asian Chinese men

KW - bladder cancer

KW - clinically insignificant

KW - cystoprostatectomy

KW - incidental prostate cancer

KW - prostate

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