Pathology of the prostate in radical cystectomy specimens: A critical review

Riccardo Autorino, Giuseppe Di Lorenzo, Rocco Damiano, Gianluca Giannarini, Marco De Sio, Liang Cheng, Rodolfo Montironi

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Our aim was to critically review clinico-pathological features of incidental prostate tumors in cystoprostatectomy specimens and to evaluate implications for patients' management. Data were identified by a structured MEDLINE search. Studies addressing incidence, pathological characteristics, and/or clinical significance of prostate tumors or related pre-malignant lesions from cystoprostatectomy series were reviewed in detail. The reported incidence of prostate adenocarcinoma in cystectomy specimens is highly variable and mostly depending on the histopathology technique of sampling. The clinical significance of these incidentally discovered cancers remains questionable, as the outcome of patients depends on the prognosis of the bladder tumor. For those candidates for prostate sparing surgery, it seems reasonable to include a routine prostate biopsy in the standard preoperative work-up as relevant PSA values to exclude cancer are lacking. Reports of prostatic urethral involvement at the time of radical cystectomy are mostly retrospective. Thus, it is likely that the true incidence of involvement with urothelial carcinoma is underreported. It has been suggested that multifocal bladder tumors, CIS in the bladder and bladder tumor location in the bladder neck are independent risk factors for prostatic urothelial carcinoma. Prostatic stromal involvement, which reflects the depth of invasion, is the most important prognostic factor. Poorly differentiated prostate adenocarcinoma and urothelial carcinoma often share overlapping morphologic features and it can be sometimes difficult to differentiate between these two entities.

Original languageEnglish
Pages (from-to)73-84
Number of pages12
JournalSurgical Oncology
Volume18
Issue number1
DOIs
StatePublished - Mar 2009

Fingerprint

Cystectomy
Prostate
Pathology
Urinary Bladder Neoplasms
Carcinoma
Neoplasms
Urinary Bladder
Adenocarcinoma
Incidence
MEDLINE
Cohort Studies
Biopsy

Keywords

  • Bladder cancer
  • Cystoprostatectomy
  • Pathology
  • Prostate cancer
  • Urothelial cancer

ASJC Scopus subject areas

  • Oncology
  • Surgery

Cite this

Autorino, R., Di Lorenzo, G., Damiano, R., Giannarini, G., De Sio, M., Cheng, L., & Montironi, R. (2009). Pathology of the prostate in radical cystectomy specimens: A critical review. Surgical Oncology, 18(1), 73-84. https://doi.org/10.1016/j.suronc.2008.07.006

Pathology of the prostate in radical cystectomy specimens : A critical review. / Autorino, Riccardo; Di Lorenzo, Giuseppe; Damiano, Rocco; Giannarini, Gianluca; De Sio, Marco; Cheng, Liang; Montironi, Rodolfo.

In: Surgical Oncology, Vol. 18, No. 1, 03.2009, p. 73-84.

Research output: Contribution to journalArticle

Autorino, R, Di Lorenzo, G, Damiano, R, Giannarini, G, De Sio, M, Cheng, L & Montironi, R 2009, 'Pathology of the prostate in radical cystectomy specimens: A critical review', Surgical Oncology, vol. 18, no. 1, pp. 73-84. https://doi.org/10.1016/j.suronc.2008.07.006
Autorino, Riccardo ; Di Lorenzo, Giuseppe ; Damiano, Rocco ; Giannarini, Gianluca ; De Sio, Marco ; Cheng, Liang ; Montironi, Rodolfo. / Pathology of the prostate in radical cystectomy specimens : A critical review. In: Surgical Oncology. 2009 ; Vol. 18, No. 1. pp. 73-84.
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