Urothelial Carcinoma Associated with Clinically Diagnosed Prostatic Adenocarcinoma
TA Flood, B Nguyen, EC Marginean, BM Purgina, KT Mai. The University of Ottawa, Ottawa, ON, Canada; The Ottawa Hospital, Ottawa, ON, Canada
Background: Prostatic adenocarcinoma (PAC) and urothelial bladder carcinoma (UC) are the two most common malignancies of the lower urinary tract in males. There is an elevated incidence of incidental PAC in patients with UC who undergo cystoprostatectomy. An increased incidence of UC is also observed in patients diagnosed with PAC. The aims of this study were 1) to validate the association between these two groups of tumors and 2) to further characterize the relationship of UC with PAC, with regards to their clinical impact (incidental versus clinically symptomatic PAC) in a population living in a Canadian city.
Design: All cases of UC and PAC between 2002 and 2008 were retrieved from the archives of our institution and retrospectively analyzed.
Results: There were a total of 790 patients with biopsies positive for UC (n = 670) or who underwent cystoprostatectomy for invasive UC (n = 120). The UC was of low grade (LGUC) in 408 of the cases and high grade (HGUC) in 382 of the cases. Of the 120 cystoprostatectomies for UC, 78 (65%) had incidental findings of PAC of which 50 were clinically insignificant and 28 were clinically significant. A total of 2568 patients were diagnosed with PAC over the six year period. Twenty-one (0.8%) of these patients (ages: 76+/- 8) had both high grade/advanced stage PAC and UC. Categorization of the twenty-one UC cases included 16 non-invasive LGUCs, 3 non-invasive HGUCs, and 2 superficially invasive HGUCs. In addition, three patients had concurrent UC and secondary PAC invading into the urinary bladder. All UC cases occurred within 6 years prior to or 1-2 years following the diagnosis of PAC.
Conclusions: Cystoprostatectomy for the management of invasive UC was associated with incidental PAC in 65% of cases, although the majority of these PACs were clinically insignificant. Conversely, a subset of patients underwent further investigations for symptomatic high grade or clinically detectable PAC. These patients were more likely to be diagnosed with incidental UC, typically of low grade.
Category: Genitourinary (including renal tumors)
Wednesday, March 11, 2009 9:30 AM
Poster Session V # 111, Wednesday Morning