Characteristics of incidental prostate cancer after radical cystoprostatectomy for bladder carcinoma in Chinese men

The purpose of this study was to analyze and characterize the clinicopathological features of incidental prostate cancer (PCa) after radical cystoprostatectomy (RCP) for bladder cancer in Chinese patients. We retrospectively reviewed 378 male patients who underwent RCP for muscle invasive bladder cancer at our center and identified 47 men with incidental PCa. The clinicopathological data of incidental PCa after RCP were compared with those of clinical T1c PCas who had radical prostatectomy at our institute. Forty-seven of the 378 patients (12.4%) were diagnosed with PCa. The incidental PCa was well-differentiated in 68.1% of patients, compared to 33.5% of patients with T1c PCa, and was significantly more unifocal than the T1c PCas. When compared to T1c PCa, the incidental PCa was more likely to be organ-confined, have negative margins and be classified as clinically insignificant. After a mean 48-month follow-up, only one patient with incidental PCa was confirmed to have bone metastasis. While 9 patients with clinical T1c PCa were found to have tumor recurrence or metastasis and 5 patients had died caused by PCa. In our study, the prevalence of incidental PCa in RCP specimens was 12.4%. These incidental PCas were likely to be unifocal, organ-confined, and clinically insignificant. The technique of capsular and apex preservation of the prostate was not a first option for patients with bladder cancer, as it increased the risk of a positive surgical margin.