Is incidentally detected prostate cancer in patients undergoing radical cystoprostatectomy clinically significant?

Roberta Mazzucchelli, Francesca Barbisan, Marina Scarpelli, Antonio Lopez-Beltran, Theodorus H. Van Der Kwast, Liang Cheng, Rodolfo Montironi

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Cystoprostatectomy specimens obtained from patients with bladder cancer provide a unique opportunity to assess the features of silent prostate adenocarcinoma (PCa). The whole-mount prostate sections of 248 totally embedded and consecutively examined radical cystoprostatectomy (RCP) specimens were reviewed to determine the incidence and features of incidentally detected PCa. PCa was considered clinically significant if any of the following criteria were present: total tumor volume, 0.5 cc or more; Gleason grade, 4 or more; extraprostatic extension; seminal vesicle invasion; lymph node metastasis (of PCa); or positive surgical margins. PCa was present in 123 (49.6%) of 248 specimens. Features were as follows: acinar adenocarcinoma, 123 (100.0%); peripheral zone location, 98 (79.7%); pT2a, 96 (78.0%);pT2b, 11 (8.9%);pT2c, 9 (7.3%);pT3a, 5 (4.1%); pT3b, 2 (1.6%); pT4, 0 (0.0%); Gleason score 6 or less, 107 (87.0%); negative margins, 119 (96.7%); pN0 for PCa, 123 (100.0%); and tumor volume less than 0.5 cc, 116 (94.3%). Of the 123 incidentally detected cases of PCa, 100 (81.3%) were considered clinically insignificant. Incidentally detected PCa is frequently observed in RCP. The majority are clinically insignificant.

Original languageEnglish
Pages (from-to)279-283
Number of pages5
JournalAmerican Journal of Clinical Pathology
Volume131
Issue number2
DOIs
StatePublished - Feb 2009

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Prostate
Prostatic Neoplasms
Adenocarcinoma
Tumor Burden
Neoplasm Grading
Seminal Vesicles
Urinary Bladder Neoplasms
Lymph Nodes
Neoplasm Metastasis
Incidence

Keywords

  • Cystoprostatectomy
  • Incidental prostate cancer
  • Prostate cancer

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Is incidentally detected prostate cancer in patients undergoing radical cystoprostatectomy clinically significant? / Mazzucchelli, Roberta; Barbisan, Francesca; Scarpelli, Marina; Lopez-Beltran, Antonio; Van Der Kwast, Theodorus H.; Cheng, Liang; Montironi, Rodolfo.

In: American Journal of Clinical Pathology, Vol. 131, No. 2, 02.2009, p. 279-283.

Research output: Contribution to journalArticle

Mazzucchelli, R, Barbisan, F, Scarpelli, M, Lopez-Beltran, A, Van Der Kwast, TH, Cheng, L & Montironi, R 2009, 'Is incidentally detected prostate cancer in patients undergoing radical cystoprostatectomy clinically significant?', American Journal of Clinical Pathology, vol. 131, no. 2, pp. 279-283. https://doi.org/10.1309/AJCP4OCYZBAN9TJU
Mazzucchelli, Roberta ; Barbisan, Francesca ; Scarpelli, Marina ; Lopez-Beltran, Antonio ; Van Der Kwast, Theodorus H. ; Cheng, Liang ; Montironi, Rodolfo. / Is incidentally detected prostate cancer in patients undergoing radical cystoprostatectomy clinically significant?. In: American Journal of Clinical Pathology. 2009 ; Vol. 131, No. 2. pp. 279-283.
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abstract = "Cystoprostatectomy specimens obtained from patients with bladder cancer provide a unique opportunity to assess the features of silent prostate adenocarcinoma (PCa). The whole-mount prostate sections of 248 totally embedded and consecutively examined radical cystoprostatectomy (RCP) specimens were reviewed to determine the incidence and features of incidentally detected PCa. PCa was considered clinically significant if any of the following criteria were present: total tumor volume, 0.5 cc or more; Gleason grade, 4 or more; extraprostatic extension; seminal vesicle invasion; lymph node metastasis (of PCa); or positive surgical margins. PCa was present in 123 (49.6{\%}) of 248 specimens. Features were as follows: acinar adenocarcinoma, 123 (100.0{\%}); peripheral zone location, 98 (79.7{\%}); pT2a, 96 (78.0{\%});pT2b, 11 (8.9{\%});pT2c, 9 (7.3{\%});pT3a, 5 (4.1{\%}); pT3b, 2 (1.6{\%}); pT4, 0 (0.0{\%}); Gleason score 6 or less, 107 (87.0{\%}); negative margins, 119 (96.7{\%}); pN0 for PCa, 123 (100.0{\%}); and tumor volume less than 0.5 cc, 116 (94.3{\%}). Of the 123 incidentally detected cases of PCa, 100 (81.3{\%}) were considered clinically insignificant. Incidentally detected PCa is frequently observed in RCP. The majority are clinically insignificant.",
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