TY  - JOUR
T1  - Contemporary Implications of Incidental Prostate Cancer in Radical Cystoprostatectomy
TT  - Radikal Sistoprostatektomide Saptanan İnsidental Prostat Kanserinin Güncel Klinik Yansımaları
AU  - Özgür, Günal
AU  - Şenoğlu, Yusuf
AU  - Akay, Halil Batur
AU  - Kars, Murat
AU  - Toper, Hasan
AU  - Tınay, İlker
AU  - Çam, Haydar Kamil
PY  - 2025
DA  - October
Y2  - 2025
DO  - 10.18521/ktd.1674768
JF  - Konuralp Medical Journal
PB  - Duzce University
WT  - DergiPark
SN  - 1309-3878
SP  - 267
EP  - 272
VL  - 17
IS  - 3
LA  - en
AB  - Objective: The aim of this study was to document the incidence, histopathologic characteristics, and clinical features of incidental prostate cancer (IPC) in a series of radical cystoprostatectomies (RCP).Method: The clinical and histopathological features of 96 male patients who underwent RCP between 2018 and 2024 were retrospectively evaluated.Results: IPC was detected in 30 (31.25%) of the patients. The majority of patients with IPC had a Gleason Score of 6 (76.67%) and organ-confined pT1-pT2 disease (90%). On the other hand, 6 (6/30, 20%) of the patients with ICP had clinically significant prostate cancer (PC) (Gleason > 3+4). Preoperative PSA values were higher in IPC patients (3.27 [1.16-5.8] ng/dL vs. 1.24 [0.79-2.36] ng/dL) (p=0.01). Survival was lower in patients with pT3-pT4 disease [13 (26.5%) vs. 25 (53.2%)], positive lymph nodes [7 (14.3%) vs. 16 (34%)], and lymphovascular invasion [12 (24.5%) vs. 29 (61.7%)] (p=0.015, 0.023, and 0.001, respectively) in the pathology of bladder cancer (BC). No difference in overall survival rates was found between patients with and without IPC [16 (32.7%) vs. 14 (29.8%)] (p=0.762).Conclusions: A higher preoperative PSA level could predict the presence of IPC in RCP patients. Approximately 20% of the PC patients had clinically significant PC, which requires PSA monitoring. However, overall survival is primarily related to BC.
KW  - Bladder Cancer
KW  - Prostate Cancer
KW  - Radical Cystectomy
KW  - Cystoprostatectomy
N2  - Amaç: Bu çalışmanın amacı, radikal sistoprostatektomi (RSP) uygulanan hastalarda insidental prostat kanseri (İPK) insidansını, histopatolojik özelliklerini ve klinik bulgularını değerlendirmektir.Yöntem: 2018–2024 yılları arasında RSP uygulanan 96 erkek hastanın klinik ve histopatolojik özellikleri retrospektif olarak değerlendirildi.Bulgular: Hastaların 30’unda (%31,25) İPK saptandı. İPK saptanan hastaların büyük çoğunluğunda Gleason skoru 6 (%76,67) ve organa sınırlı (pT1–pT2) tümör (%90) mevcuttu. İPK saptanan 6 hastada (6/30, %20) klinik olarak anlamlı prostat kanseri (Gleason > 3+4) saptandı. Preoperatif PSA düzeyleri İPK saptanan hastalarda daha yüksekti (3,27 [1,16–5,8] ng/dL’ye karşılık 1,24 [0,79–2,36] ng/dL) (p=0,01). Mesane kanseri (MK) patolojisinde evre pT3–pT4 hastalık olan, lenf nodu metastazı bulunan ve lenfovasküler invazyon gösteren hastalarda sağkalım oranları daha düşüktü [sırasıyla 13 (%26,5) vs. 25 (%53,2); 7 (%14,3) vs. 16 (%34); 12 (%24,5) vs. 29 (%61,7)] (p=0,015, 0,023 ve 0,001). İPK varlığı ile genel sağkalım oranları arasında anlamlı bir fark saptanmadı [İPK olanlarda 16 (%32,7) vs. olmayanlarda 14 (%29,8)] (p=0,762).Sonuç: Yüksek preoperatif PSA düzeyleri, RSP uygulanan hastalarda İPK varlığının öngörücüsü olabilir. Prostat kanseri saptanan olguların yaklaşık %20’sinde klinik olarak anlamlı prostat kanseri mevcut olup, bu hastalarda PSA takibi önerilmektedir. Bununla birlikte, genel sağkalım esas olarak mesane kanseri ile ilişkilidir.
CR  - 1.	Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin. 2024;74(1):12-49.
CR  - 2.	Bell KJ, Del Mar C, Wright G, Dickinson J, Glasziou P. Prevalence of incidental prostate cancer: A systematic review of autopsy studies. Int J Cancer. 2015;137(7):1749-57.
CR  - 3.	Cornford P, van den Bergh RCN, Briers E, van den Broeck T, Brunckhorst O, Darraugh J, et al. EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines on prostate cancer-2024 update. part I: screening, diagnosis, and local treatment with curative intent. Eur Urol. 2024;86(2):148-63.
CR  - 4.	Lopez-Beltran A, Cheng L, Montorsi F, Scarpelli M, Raspollini MR, Montironi R. Concomitant bladder cancer and prostate cancer: challenges and controversies. Nat Rev Urol. 2017;14(10):620-9.
CR  - 5.	Buse S, Höfner T, Müller SC, Hermann E, Wieland WF, May M, et al. Characterization and risk stratification of prostate cancer in patients undergoing radical cystoprostatectomy. Int J Urol. 2013;20(9):866-71.
CR  - 6.	Sruogis A, Ulys A, Smailyte G, Kardelis Z, Kulboka A, Anglickienė G, et al. Incidentally found prostate cancer and influence on overall survival after radical cystoprostatectomy. Prostate Cancer. 2012;2012:690210.
CR  - 7.	Kimura T, Onuma H, Sato S, Inaba H, Fukuokaya W, Urabe F, et al. Incidental prostate cancer in radical cystoprostatectomy specimens is associated with worse overall survival. Bladder Cancer. 2021;7(2):205-11.
CR  - 8.	Fahmy O, Khairul-Asri MG, Schubert T, Renninger M, Stenzl A, Gakis G. Clinicopathological features and prognostic value of incidental Prostatic Adenocarcinoma in radical cystoprostatectomy specimens: a systematic review and meta-analysis of 13,140 patients. J Urol. 2017;197(2):385-90.
CR  - 9.	Jønck S, Helgstrand JT, Røder MA, Klemann N, Grønkaer Toft B, Brasso K. The prognostic impact of incidental prostate cancer following radical cystoprostatectomy: a nationwide analysis. Scand J Urol. 2018;52(5-6):358-63.
CR  - 10.	Pignot G, Salomon L, Neuzillet Y, Masson-Lecomte A, Lebacle C, Patard JJ, et al. Clinicopathological characteristics of incidental prostate cancer discovered from radical cystoprostatectomy specimen: a multicenter French study. Ann Surg Oncol. 2014;21(2):684-90.
CR  - 11.	Malte R, Kluth LA, Kaushik D, Boorjian SA, Abufaraj M, Foerster B, et al. Frequency and prognostic significance of incidental prostate cancer at radical cystectomy: results from an international retrospective study. Eur J Surg Oncol. 2017;43(11):2193-9.
CR  - 12.	Scilipoti P, Liedberg F, Garmo H, Orrason AW, Stattin P, Westerberg M. Risk of prostate cancer death in men diagnosed with prostate cancer at cystoprostat¬ectomy. A nationwide population-based study. Scand J Urol. 2024;59:98-103.
CR  - 13.	Tang S, Hao H, Fang D, Zheng W, Ge P, Su X, et al. Prostate cancer incidentally discovered at the time of radical cystoprostatectomy does not decrease overall survival: results from a large Chinese medical center. Int Braz J Urol. 2018;44(2):258-66.
CR  - 14.	Wu K, Liu X, Tang Y, Wang X, Li X. Clinicopathologic characteristics and outcomes of prostate cancer incidentally discovered at the time of radical cystoprostatectomy: a population-based cohort study. Int J Surg. 2024;110(7):4023-30.
CR  - 15.	Bruins HM, Djaladat H, Ahmadi H, Sherrod A, Cai J, Miranda G, et al. Incidental prostate cancer in patients with bladder urothelial carcinoma: comprehensive analysis of 1,476 radical cystoprostatectomy specimens. J Urol. 2013;190(5):1704-9.
CR  - 16.	Kaelberer JB, O'Donnell MA, Mitchell DL, Snow AN, Mott SL, Buatti JM, et al. Incidental prostate cancer diagnosed at radical cystoprostatectomy for bladder cancer: disease-specific outcomes and survival. Prostate Int. 2016;4(3):107-12.
CR  - 17.	Li S, Chen R, Raj A, Xue N, Zhao F, Shen X, et al. Impact of the time of surgical delay on survival in patients with muscle-invasive bladder cancer. Front Oncol. 2022;12:1001843.
CR  - 18.	Kutikov A, Weinberg DS, Edelman MJ, Horwitz EM, Uzzo RG, Fisher RI. A war on two fronts: cancer care in the Time of COVID-19. Ann Intern Med. 2020;172(11):756-8.
CR  - 19.	Naspro R, Da Pozzo LF. Urology in the time of corona. Nat Rev Urol. 2020;17(5):251-3.
UR  - https://doi.org/10.18521/ktd.1674768
L1  - https://dergipark.org.tr/en/download/article-file/4767300
ER  -