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Abstract

Volume 11, Issue 1 (January 2009) 11, 104–108; 10.1038/aja.2008.15

Prevalence of incidental prostate cancer in patients undergoing radical cystoprostatectomy: data from China and other Asian countries

Yi-Ping Zhu, Ding-Wei Ye, Xu-Dong Yao, Shi-Lin Zhang, Bo Dai, Hai-Liang Zhang, Yi-Jun Shen, Yao Zhu and Guo-Hai Shi

Department of Urology, Cancer Hospital, Fudan University, Shanghai 200032, China

Correspondence: Ding-Wei Ye, Department of Urology, Cancer Hospital, Fudan University and Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China. Fax: +86-21-8572-6916. E-mail: dwye@shca.org.cn

Received 5 July 2008; Revised 28 July 2008; Accepted 28 September 2008; Published online 1 December 2008

Abstract

The purpose of this study is to investigate the frequency of prostate cancer (Pca) discovered incidentally in radical cystoprostatectomy specimens in Asia and to determine the feasibility of prostate-sparing cystectomy (PSC) for Asian patients. Ninety-two male bladder cancer patients who underwent radical cystoprostatectomy at our center between January 2003 and January 2008 were included in this study. The mean age of patients was 67.1 years (range: 32–75 years). Prostate-specific antigen (PSA) levels and digital rectal examination (DRE) results before surgery were obtained retrospectively. Prostates of all patients were embedded and sectioned at 5-mm intervals. The same pathologist examined the prostatic tissues from radical cystoprostatectomy specimens. Finally, a structured literature review was performed using MEDLINE and PUBMED to estimate the occurrence of incidental Pca in Asia. Of the 92 patients, 3 (3.3%) were found to have Pca; in one out of three (33.3%) patients the disease was clinically significant due to a Gleason grade 4 carcinoma. Eight articles were included in our review. The overall incidence of Pca discovered incidentally in radical cystoprostatectomy specimens in Asia was 9.9% (64/642). When age was restricted to < 60 years, only 7 out of 222 (3.2%) patients were found to have synchronous Pca, and none of the cases was clinically significant. The occurrence of Pca in radical cystoprostatectomy specimens in Asia is much lower than that in Western countries. PSC might be feasible for Asian patients under a strict preoperative selection.

Keywords: bladder cancer, cystoprostatectomy, incidental, prostate cancer, prostate-sparing cystectomy

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