Frequency and prognostic significance of incidental prostate cancer at radical cystectomy: Results from an international retrospective study

R Malte, LA Kluth, D Kaushik, SA Boorjian, M Abufaraj, B Foerster, M Rink, K Gust, F Roghmann, J Noldus, D Vordos, M Hagiwara, E Kikuchi, M Ikeda, K Matsumoto, PI Karakiewicz, M Rouprêt, A Briganti, DS Scherr, SF ShariatV Seebacher

Research output: Contribution to journalArticle

Abstract

Objectives: To analyze the frequency of incidental prostate cancer (PC) at radical cystoprostatectomy (RC) for urothelial carcinoma of the bladder (UCB) and its association with survival outcomes in an international cohort. Patients and methods: In this retrospective study, we included 2114 who underwent RC and lymphadenectomy for UCB between 1976 and 2012 male patients from seven institutions. Univariable and multivariable Cox regression models addressed the association of incidental PC with cancer-specific mortality and overall mortality after RC. Results: Overall, incidental PC was found in 513 (24.3%) patients with the lowest frequency in a Japanese center (23/164, 11.2%) and the highest frequency in a North American center (122/325, 37.5%), respectively (p < 0.001). Within a median follow up of 27 months (IQR: 50 months), 20 patients (3.9%) were diagnosed with biochemical recurrence (BCR) and none of the patients died of PC. PC pathological tumor stage was more advanced in patients experiencing BCR (p < 0.001). In multivariable Cox regression analyses adjusted for standard clinicopathologic features, incidental PC was not associated with cancer-specific (HR: 1.11, 95% CI: 0.91-1.35, p = 0.30) or overall mortality (HR: 1.06, 95% CI: 0.83-1.35, p = 0.65). Conclusions: Incidental PC at RC for UCB is a frequent event. However, the majority of PC cases are well-differentiated and organ-confined. Presence of incidental PC shows significant geographic differences. The risk of BCR after incidental PC is low and incidental PC is not associated with survival in UCB patients treated with RC. © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology.
Original languageEnglish
Pages (from-to)2193-2199
Number of pages7
JournalEuropean Journal of Surgical Oncology
Volume43
Issue number11
DOIs
Publication statusPublished - 2017

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Cystectomy
Prostatic Neoplasms
Retrospective Studies
Urinary Bladder
Carcinoma
Recurrence
Mortality
Neoplasms
Survival
Lymph Node Excision
Proportional Hazards Models
Regression Analysis

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Frequency and prognostic significance of incidental prostate cancer at radical cystectomy: Results from an international retrospective study. / Malte, R; Kluth, LA; Kaushik, D; Boorjian, SA; Abufaraj, M; Foerster, B; Rink, M; Gust, K; Roghmann, F; Noldus, J; Vordos, D; Hagiwara, M; Kikuchi, E; Ikeda, M; Matsumoto, K; Karakiewicz, PI; Rouprêt, M; Briganti, A; Scherr, DS; Shariat, SF; Seebacher, V.

In: European Journal of Surgical Oncology, Vol. 43, No. 11, 2017, p. 2193-2199.

Research output: Contribution to journalArticle

Malte, R, Kluth, LA, Kaushik, D, Boorjian, SA, Abufaraj, M, Foerster, B, Rink, M, Gust, K, Roghmann, F, Noldus, J, Vordos, D, Hagiwara, M, Kikuchi, E, Ikeda, M, Matsumoto, K, Karakiewicz, PI, Rouprêt, M, Briganti, A, Scherr, DS, Shariat, SF & Seebacher, V 2017, 'Frequency and prognostic significance of incidental prostate cancer at radical cystectomy: Results from an international retrospective study', European Journal of Surgical Oncology, vol. 43, no. 11, pp. 2193-2199. https://doi.org/10.1016/j.ejso.2017.08.013
Malte, R ; Kluth, LA ; Kaushik, D ; Boorjian, SA ; Abufaraj, M ; Foerster, B ; Rink, M ; Gust, K ; Roghmann, F ; Noldus, J ; Vordos, D ; Hagiwara, M ; Kikuchi, E ; Ikeda, M ; Matsumoto, K ; Karakiewicz, PI ; Rouprêt, M ; Briganti, A ; Scherr, DS ; Shariat, SF ; Seebacher, V. / Frequency and prognostic significance of incidental prostate cancer at radical cystectomy: Results from an international retrospective study. In: European Journal of Surgical Oncology. 2017 ; Vol. 43, No. 11. pp. 2193-2199.
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abstract = "Objectives: To analyze the frequency of incidental prostate cancer (PC) at radical cystoprostatectomy (RC) for urothelial carcinoma of the bladder (UCB) and its association with survival outcomes in an international cohort. Patients and methods: In this retrospective study, we included 2114 who underwent RC and lymphadenectomy for UCB between 1976 and 2012 male patients from seven institutions. Univariable and multivariable Cox regression models addressed the association of incidental PC with cancer-specific mortality and overall mortality after RC. Results: Overall, incidental PC was found in 513 (24.3{\%}) patients with the lowest frequency in a Japanese center (23/164, 11.2{\%}) and the highest frequency in a North American center (122/325, 37.5{\%}), respectively (p < 0.001). Within a median follow up of 27 months (IQR: 50 months), 20 patients (3.9{\%}) were diagnosed with biochemical recurrence (BCR) and none of the patients died of PC. PC pathological tumor stage was more advanced in patients experiencing BCR (p < 0.001). In multivariable Cox regression analyses adjusted for standard clinicopathologic features, incidental PC was not associated with cancer-specific (HR: 1.11, 95{\%} CI: 0.91-1.35, p = 0.30) or overall mortality (HR: 1.06, 95{\%} CI: 0.83-1.35, p = 0.65). Conclusions: Incidental PC at RC for UCB is a frequent event. However, the majority of PC cases are well-differentiated and organ-confined. Presence of incidental PC shows significant geographic differences. The risk of BCR after incidental PC is low and incidental PC is not associated with survival in UCB patients treated with RC. {\circledC} 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology.",
author = "R Malte and LA Kluth and D Kaushik and SA Boorjian and M Abufaraj and B Foerster and M Rink and K Gust and F Roghmann and J Noldus and D Vordos and M Hagiwara and E Kikuchi and M Ikeda and K Matsumoto and PI Karakiewicz and M Roupr{\^e}t and A Briganti and DS Scherr and SF Shariat and V Seebacher",
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TY - JOUR

T1 - Frequency and prognostic significance of incidental prostate cancer at radical cystectomy: Results from an international retrospective study

AU - Malte, R

AU - Kluth, LA

AU - Kaushik, D

AU - Boorjian, SA

AU - Abufaraj, M

AU - Foerster, B

AU - Rink, M

AU - Gust, K

AU - Roghmann, F

AU - Noldus, J

AU - Vordos, D

AU - Hagiwara, M

AU - Kikuchi, E

AU - Ikeda, M

AU - Matsumoto, K

AU - Karakiewicz, PI

AU - Rouprêt, M

AU - Briganti, A

AU - Scherr, DS

AU - Shariat, SF

AU - Seebacher, V

PY - 2017

Y1 - 2017

N2 - Objectives: To analyze the frequency of incidental prostate cancer (PC) at radical cystoprostatectomy (RC) for urothelial carcinoma of the bladder (UCB) and its association with survival outcomes in an international cohort. Patients and methods: In this retrospective study, we included 2114 who underwent RC and lymphadenectomy for UCB between 1976 and 2012 male patients from seven institutions. Univariable and multivariable Cox regression models addressed the association of incidental PC with cancer-specific mortality and overall mortality after RC. Results: Overall, incidental PC was found in 513 (24.3%) patients with the lowest frequency in a Japanese center (23/164, 11.2%) and the highest frequency in a North American center (122/325, 37.5%), respectively (p < 0.001). Within a median follow up of 27 months (IQR: 50 months), 20 patients (3.9%) were diagnosed with biochemical recurrence (BCR) and none of the patients died of PC. PC pathological tumor stage was more advanced in patients experiencing BCR (p < 0.001). In multivariable Cox regression analyses adjusted for standard clinicopathologic features, incidental PC was not associated with cancer-specific (HR: 1.11, 95% CI: 0.91-1.35, p = 0.30) or overall mortality (HR: 1.06, 95% CI: 0.83-1.35, p = 0.65). Conclusions: Incidental PC at RC for UCB is a frequent event. However, the majority of PC cases are well-differentiated and organ-confined. Presence of incidental PC shows significant geographic differences. The risk of BCR after incidental PC is low and incidental PC is not associated with survival in UCB patients treated with RC. © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology.

AB - Objectives: To analyze the frequency of incidental prostate cancer (PC) at radical cystoprostatectomy (RC) for urothelial carcinoma of the bladder (UCB) and its association with survival outcomes in an international cohort. Patients and methods: In this retrospective study, we included 2114 who underwent RC and lymphadenectomy for UCB between 1976 and 2012 male patients from seven institutions. Univariable and multivariable Cox regression models addressed the association of incidental PC with cancer-specific mortality and overall mortality after RC. Results: Overall, incidental PC was found in 513 (24.3%) patients with the lowest frequency in a Japanese center (23/164, 11.2%) and the highest frequency in a North American center (122/325, 37.5%), respectively (p < 0.001). Within a median follow up of 27 months (IQR: 50 months), 20 patients (3.9%) were diagnosed with biochemical recurrence (BCR) and none of the patients died of PC. PC pathological tumor stage was more advanced in patients experiencing BCR (p < 0.001). In multivariable Cox regression analyses adjusted for standard clinicopathologic features, incidental PC was not associated with cancer-specific (HR: 1.11, 95% CI: 0.91-1.35, p = 0.30) or overall mortality (HR: 1.06, 95% CI: 0.83-1.35, p = 0.65). Conclusions: Incidental PC at RC for UCB is a frequent event. However, the majority of PC cases are well-differentiated and organ-confined. Presence of incidental PC shows significant geographic differences. The risk of BCR after incidental PC is low and incidental PC is not associated with survival in UCB patients treated with RC. © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology.

U2 - 10.1016/j.ejso.2017.08.013

DO - 10.1016/j.ejso.2017.08.013

M3 - Article

VL - 43

SP - 2193

EP - 2199

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

SN - 0748-7983

IS - 11

ER -