Abstract
To determine if patients with bladder cancer have a higher incidence of unsuspected
prostate cancer, 40 cases were studied. All except one case had no evidence
of prostate cancer on preoperative clinical assessment. Detailed pathological
evaluation of cystoprostatectomy specimens with sections at 2- to 3-
mm intervals was done. Adenocarcinoma of the prostate was identified in 18
of 40 patients (45 %). Multifocal prostatic intraepithelial neoplasia (PIN) was
present in 19 cases (47.5 %); 4 ( 10 %) without an associated prostate cancer and
15 (37.5%) in conjunction with adenocarcinoma of the prostate. Twelve cases
of unsuspected prostate cancer were stage pTla, 4 were pTlb, and 2 were pT3.
No patients exhibited nodal or distant métastasés by the prostate cancer. At a
mean follow-up of 15.2 months (range 3-34 months), 37 of the 40 patients are
alive. Among prostate cancer patients, no clinical or biochemical evidence of
disease recurrence or prostate cancer related mortality has been observed. Our
findings support the previously reported high incidence rate of prostate cancer
in patients undergoing cystoprostatectomy for bladder cancer. This, though,
may not be higher than the observed incidence in an age-matched general
population. We recommend DRE and PSA as part of the bladder cancer workup
in males, and complete removal of the prostate at cystoprostatectomy to
prevent the dilemma of residual prostate cancer.
