Prediction of Prostatic Involvement by Urothelial Carcinoma in Radical Cystoprostatectomy for Bladder Cancer

Roberta Mazzucchelli, Francesca Barbisan, Alfredo Santinelli, Marina Scarpelli, Andrea B. Galosi, Antonio Lopez-Beltran, Liang Cheng, Ziya Kirkali, Rodolfo Montironi

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Objectives: To ascertain which variables of bladder urothelial carcinoma (UC) might be useful in predicting either UC involving the prostate (UCP) or incidental prostate adenocarcinoma in radical cystoprostatectomy specimens. Methods: The bladder and whole-mount prostate sections of 248 radical cystoprostatectomy specimens were reviewed. Stepwise discriminant analysis was used to predict UCP or incidental prostate adenocarcinoma. Results: UCP was present in 94 patients (37.9%). UC originated from the prostatic urethra and periurethral ducts in 78 (31.45%), and isolated direct extension of UC from the bladder was present in 16 patients (6.45%). The periurethral ducts coexisted with direct extension of bladder UC in 11 patients (4.4%). Prostate adenocarcinoma was identified in 123 patients (49.6%). Carcinoma in situ and high-grade urothelial papillary carcinoma were seen in 8 (3.2%) and 5 (2.0%) patients, respectively. In 57 (23%), 64 (25.8%), and 87 (35.1%) patients, UC had invaded the subepithelial connective tissue, muscularis propria, and perivesical tissue, respectively. UC was multifocal in 53 patients (21.4%). The tumor was in the trigone and bladder neck in 160 patients (64.5%). Of the 248 patients, 98 (39.5%) had a history of recurrence. Stepwise discriminant analysis selected 3 variables of bladder UC (previous recurrence and location and number of foci) and correctly predicted the group in 72.2% of patients without and with UCP. Discriminant analysis selected 2 variables of bladder UC (focality and previous recurrence) and correctly predicted the group in 57.7% of patients without and with prostate adenocarcinoma. Conclusions: Our approach can identify bladder UC variables that could guide urologists in the selection of the most appropriate surgical procedure.

Original languageEnglish (US)
Pages (from-to)385-390
Number of pages6
JournalUrology
Volume74
Issue number2
DOIs
StatePublished - Aug 1 2009

ASJC Scopus subject areas

  • Urology

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    Mazzucchelli, R., Barbisan, F., Santinelli, A., Scarpelli, M., Galosi, A. B., Lopez-Beltran, A., Cheng, L., Kirkali, Z., & Montironi, R. (2009). Prediction of Prostatic Involvement by Urothelial Carcinoma in Radical Cystoprostatectomy for Bladder Cancer. Urology, 74(2), 385-390. https://doi.org/10.1016/j.urology.2009.03.010