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Erschienen in: Virchows Archiv 6/2012

01.12.2012 | Original Article

Potentially clinically relevant prostate cancer is found more frequently after complete than after partial histopathological processing of radical cystoprostatectomy specimens

verfasst von: H. M. Fritsche, A. Aziz, F. Eder, W. Otto, S. Denzinger, W. F. Wieland, M. May, F. Hofstädter, A. Hartmann, M. Burger

Erschienen in: Virchows Archiv | Ausgabe 6/2012

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Abstract

Incidental prostate cancer is often found in cystoprostatectomy specimens. The presence of a clinically significant tumour has an impact on follow-up strategies. In prostatectomy specimen for prostate cancer, whole-mount sections improve diagnostic accuracy. The present study compares detection of incidental prostate cancer in complete to routine processing. We included 295 consecutive patients who underwent radical cystoprostatectomy. Between 01/1995 and 12/2003 (period I), specimens of 129 patients were partially processed, whereas between 01/2004 and 03/2009 (period II), specimens of 166 patients were completely processed. Incidental prostate cancer was detected overall in 91 (30.8 %) patients. Prostate cancer was detected in 24 (18.6 %) patients in period 1 and in 67 (40.4 %) patients in period 2 (p < 0.001). Potentially clinically significant prostate cancer was detected in 12 (9.2 %) and 29 (17.5 %) patients, respectively (p = 0.044). Complete embedding and processing of cystoprostatectomy specimen yield significantly more potentially clinically relevant prostate cancers. The present data suggest that notably in younger men the specimens should be completely processed.
Literatur
1.
Zurück zum Zitat Stenzl A, Cowan NC, De Santis M, Kuczyk MA, Merseburger AS, Ribal MJ, Sherif A, Witjes JA, European Association of Urology (2011) The updated EAU guidelines on muscle-invasive and metastatic bladder cancer. Eur Urol 59:1009–1018PubMedCrossRef Stenzl A, Cowan NC, De Santis M, Kuczyk MA, Merseburger AS, Ribal MJ, Sherif A, Witjes JA, European Association of Urology (2011) The updated EAU guidelines on muscle-invasive and metastatic bladder cancer. Eur Urol 59:1009–1018PubMedCrossRef
2.
Zurück zum Zitat Babjuk M, Oosterlinck W, Sylvester R, Kaasinen E, Böhle A, Palou-Redorta J, Roupret M, European Association of Urology (2011) EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder. Eur Urol 59:997–1008PubMedCrossRef Babjuk M, Oosterlinck W, Sylvester R, Kaasinen E, Böhle A, Palou-Redorta J, Roupret M, European Association of Urology (2011) EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder. Eur Urol 59:997–1008PubMedCrossRef
3.
Zurück zum Zitat Nagele U, Anastasiadis AG, Stenzl A, Kuczyk M (2011) Radical cystectomy with orthotopic neobladder for invasive bladder cancer: a critical analysis of long-term oncological, functional, and quality of life results. World J Urol. doi:10.1007/s0034501106494 Nagele U, Anastasiadis AG, Stenzl A, Kuczyk M (2011) Radical cystectomy with orthotopic neobladder for invasive bladder cancer: a critical analysis of long-term oncological, functional, and quality of life results. World J Urol. doi:10.​1007/​s0034501106494
4.
Zurück zum Zitat Gakis G, Schilling D, Bedke J et al (2010) Incidental prostate cancer at radical cystoprostatectomy: implications for apex-sparing surgery. BJU Int 105:468–471PubMedCrossRef Gakis G, Schilling D, Bedke J et al (2010) Incidental prostate cancer at radical cystoprostatectomy: implications for apex-sparing surgery. BJU Int 105:468–471PubMedCrossRef
5.
Zurück zum Zitat Damiano R, Di Lorenzo G, Cantiello F et al (2007) Clinicopathological features of prostate adenocarcinoma incidentally discovered at time of radical cystectomy: an evidence based analysis. Eur Urol 52:648–657PubMedCrossRef Damiano R, Di Lorenzo G, Cantiello F et al (2007) Clinicopathological features of prostate adenocarcinoma incidentally discovered at time of radical cystectomy: an evidence based analysis. Eur Urol 52:648–657PubMedCrossRef
6.
Zurück zum Zitat Kouriefs C, Fazili T, Masood S, Naseem MS, Mufti GR (2005) Incidentally detected prostate cancer in cystoprostatectomy specimens. Urol Int 275:213–216CrossRef Kouriefs C, Fazili T, Masood S, Naseem MS, Mufti GR (2005) Incidentally detected prostate cancer in cystoprostatectomy specimens. Urol Int 275:213–216CrossRef
7.
Zurück zum Zitat Revelo MP, Cookson MS, Chang SS, Shook MF, Smith JA Jr, Shappell SB (2004) Incidence and location of prostate and urothelial carcinoma in prostates from cystoprostatectomies: implications for possible apical sparing surgery. J Urol 171:646–651PubMedCrossRef Revelo MP, Cookson MS, Chang SS, Shook MF, Smith JA Jr, Shappell SB (2004) Incidence and location of prostate and urothelial carcinoma in prostates from cystoprostatectomies: implications for possible apical sparing surgery. J Urol 171:646–651PubMedCrossRef
8.
Zurück zum Zitat Ruffion A, Manel A, Massoud W et al (2005) Preservation of prostate during radical cystectomy: evaluation of prevalence of prostate cancer associated with bladder cancer. Urology 65:703–707PubMedCrossRef Ruffion A, Manel A, Massoud W et al (2005) Preservation of prostate during radical cystectomy: evaluation of prevalence of prostate cancer associated with bladder cancer. Urology 65:703–707PubMedCrossRef
9.
Zurück zum Zitat Pettus JA, Al-Ahmadie H, Barocas DA, Koppie TM, Herr H, Donat SM, Dalbagni G, Reuter VE, Olgac S, Bochner BH (2008) Risk assessment of prostatic pathology in patients undergoing radical cystoprostatectomy. Eur Urol 53:370–375PubMedCrossRef Pettus JA, Al-Ahmadie H, Barocas DA, Koppie TM, Herr H, Donat SM, Dalbagni G, Reuter VE, Olgac S, Bochner BH (2008) Risk assessment of prostatic pathology in patients undergoing radical cystoprostatectomy. Eur Urol 53:370–375PubMedCrossRef
10.
Zurück zum Zitat Mazzucchelli R, Barbisan F, Scarpelli M, Lopez-Beltran A, van der Kwast TH, Cheng L, Montironi R (2009) Is incidentally detected prostate cancer in patients undergoing radical cystoprostatectomy clinically significant? Am J Clin Pathol 131:279–283PubMedCrossRef Mazzucchelli R, Barbisan F, Scarpelli M, Lopez-Beltran A, van der Kwast TH, Cheng L, Montironi R (2009) Is incidentally detected prostate cancer in patients undergoing radical cystoprostatectomy clinically significant? Am J Clin Pathol 131:279–283PubMedCrossRef
11.
Zurück zum Zitat Heidenreich A, Bellmunt J, Bolla M, European Association of Urology et al (2011) EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol 59:61–71PubMedCrossRef Heidenreich A, Bellmunt J, Bolla M, European Association of Urology et al (2011) EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol 59:61–71PubMedCrossRef
12.
Zurück zum Zitat van der Kwast TH, Amin MB, Billis A, Prostate Cancer Group ISUP et al (2011) International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 2: T2 substaging and prostate cancer volume. Mod Pathol 24:16–25PubMedCrossRef van der Kwast TH, Amin MB, Billis A, Prostate Cancer Group ISUP et al (2011) International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 2: T2 substaging and prostate cancer volume. Mod Pathol 24:16–25PubMedCrossRef
13.
Zurück zum Zitat Sehdev AE, Pan CC, Epstein JI (2011) Comparative analysis of sampling methods for grossing radical prostatectomy specimens performed for nonpalpable (stage T1c) prostatic adenocarcinoma. Hum Pathol 32:494–499CrossRef Sehdev AE, Pan CC, Epstein JI (2011) Comparative analysis of sampling methods for grossing radical prostatectomy specimens performed for nonpalpable (stage T1c) prostatic adenocarcinoma. Hum Pathol 32:494–499CrossRef
14.
Zurück zum Zitat May M, Siegsmund M, Hammermann F, Loy V, Gunia S (2007) Visual estimation of the tumour volume in prostate cancer: a useful means for predicting biochemical-free survival after radical prostatectomy? Prostate Cancer Prostatic Dis 10:66–71PubMedCrossRef May M, Siegsmund M, Hammermann F, Loy V, Gunia S (2007) Visual estimation of the tumour volume in prostate cancer: a useful means for predicting biochemical-free survival after radical prostatectomy? Prostate Cancer Prostatic Dis 10:66–71PubMedCrossRef
15.
Zurück zum Zitat Epstein JI, Walsh PC, Carmichael M, Brendler CB (1994) Pathologic and clinical findings to predict tumor extent of nonpalpable (stage T1c) prostate cancer. JAMA 271:368–374PubMedCrossRef Epstein JI, Walsh PC, Carmichael M, Brendler CB (1994) Pathologic and clinical findings to predict tumor extent of nonpalpable (stage T1c) prostate cancer. JAMA 271:368–374PubMedCrossRef
16.
Zurück zum Zitat Lee SH, Chang PL, Chen SM, Sun GH, Chen CL, Shen BY, Wu YS, Tsui KH (2006) Synchronous primary carcinomas of the bladder and prostate. Asian J Androl 8:357–359PubMedCrossRef Lee SH, Chang PL, Chen SM, Sun GH, Chen CL, Shen BY, Wu YS, Tsui KH (2006) Synchronous primary carcinomas of the bladder and prostate. Asian J Androl 8:357–359PubMedCrossRef
17.
Zurück zum Zitat Moutzouris G, Barbatis C, Plastiras D, Mertziotis N, Katsifotis C, Presvelos V, Theodorou C (1999) Incidence and histological findings of unsuspected prostatic adenocarcinoma in radical cystoprostatectomy for transitional cell carcinoma of the bladder. Scand J Urol Nephrol 33:27–30PubMed Moutzouris G, Barbatis C, Plastiras D, Mertziotis N, Katsifotis C, Presvelos V, Theodorou C (1999) Incidence and histological findings of unsuspected prostatic adenocarcinoma in radical cystoprostatectomy for transitional cell carcinoma of the bladder. Scand J Urol Nephrol 33:27–30PubMed
18.
Zurück zum Zitat Abdelhady M, Abusamra A, Pautler SE, Chin JL, Izawa JI (2007) Clinically significant prostate cancer found incidentally in radical cystoprostatectomy specimens. BJU Int 99:326–329PubMedCrossRef Abdelhady M, Abusamra A, Pautler SE, Chin JL, Izawa JI (2007) Clinically significant prostate cancer found incidentally in radical cystoprostatectomy specimens. BJU Int 99:326–329PubMedCrossRef
19.
Zurück zum Zitat Winfield HN, Reddy PK, Lange PH (1987) Coexisting adenocarcinoma of prostate in patients undergoing cystoprostatectomy for bladder cancer. Urology 30:100–101PubMedCrossRef Winfield HN, Reddy PK, Lange PH (1987) Coexisting adenocarcinoma of prostate in patients undergoing cystoprostatectomy for bladder cancer. Urology 30:100–101PubMedCrossRef
20.
Zurück zum Zitat Pritchett TR, Moreno J, Warner NE et al (1988) Unsuspected prostatic adenocarcinoma in patients who have undergone radical cystoprostatectomy for transitional cell carcinoma of the bladder. J Urol 139:1214–1216PubMed Pritchett TR, Moreno J, Warner NE et al (1988) Unsuspected prostatic adenocarcinoma in patients who have undergone radical cystoprostatectomy for transitional cell carcinoma of the bladder. J Urol 139:1214–1216PubMed
21.
Zurück zum Zitat Montie JE, Wood DP Jr, Pontes JE, Boyett JM, Levin HS (1989) Adenocarcinoma of the prostate in cystoprostatectomy specimens removed for bladder cancer. Cancer 63:381–385PubMedCrossRef Montie JE, Wood DP Jr, Pontes JE, Boyett JM, Levin HS (1989) Adenocarcinoma of the prostate in cystoprostatectomy specimens removed for bladder cancer. Cancer 63:381–385PubMedCrossRef
22.
Zurück zum Zitat Kabalin JN, McNeal JE, Price HM, Freiha FS, Stamey TA (1989) Unsuspected adenocarcinoma of the prostate in patients undergoing cystoprostatectomy for other causes: incidence, histology and morphometric observations. J Urol 141:1091–1094PubMed Kabalin JN, McNeal JE, Price HM, Freiha FS, Stamey TA (1989) Unsuspected adenocarcinoma of the prostate in patients undergoing cystoprostatectomy for other causes: incidence, histology and morphometric observations. J Urol 141:1091–1094PubMed
23.
Zurück zum Zitat Abbas F, Hochberg D, Civantos F, Soloway M (1996) Incidental prostatic adenocarcinoma in patients undergoing radical cystoprostatectomy for bladder cancer. Eur Urol 30:322–326PubMed Abbas F, Hochberg D, Civantos F, Soloway M (1996) Incidental prostatic adenocarcinoma in patients undergoing radical cystoprostatectomy for bladder cancer. Eur Urol 30:322–326PubMed
24.
Zurück zum Zitat Aydin O, Cosar EF, Varinli S, Bugdatci R, Tansung Z (1999) Prostatic intraepithelial neoplasia in prostate specimens: frequency, significance and relationship to the sampling of the specimen (a retrospective study of 121 cases). Int Urol Nephrol 31:687–697PubMedCrossRef Aydin O, Cosar EF, Varinli S, Bugdatci R, Tansung Z (1999) Prostatic intraepithelial neoplasia in prostate specimens: frequency, significance and relationship to the sampling of the specimen (a retrospective study of 121 cases). Int Urol Nephrol 31:687–697PubMedCrossRef
25.
Zurück zum Zitat Yang CR, Ou YC, Ho HC et al (1999) Unsuspected prostate carcinoma and prostatic intraepithelial neoplasm in Taiwanese patients undergoing cystoprostatectomy. Mol Urol 3:33–39PubMed Yang CR, Ou YC, Ho HC et al (1999) Unsuspected prostate carcinoma and prostatic intraepithelial neoplasm in Taiwanese patients undergoing cystoprostatectomy. Mol Urol 3:33–39PubMed
26.
Zurück zum Zitat Conrad S, Hautmann SH, Henke RP et al (2001) Detection and characterization of early prostate cancer by six systematic biopsies and fine needle aspiration cytology in prostates from bladder cancer patients. Eur Urol 39:25–29PubMedCrossRef Conrad S, Hautmann SH, Henke RP et al (2001) Detection and characterization of early prostate cancer by six systematic biopsies and fine needle aspiration cytology in prostates from bladder cancer patients. Eur Urol 39:25–29PubMedCrossRef
27.
Zurück zum Zitat Prange W, Erbersdobler A, Hammerer P et al (2001) High-grade prostatic intraepithelial neoplasia in cystoprostatectomy specimens. Eur Urol 39:30–31PubMedCrossRef Prange W, Erbersdobler A, Hammerer P et al (2001) High-grade prostatic intraepithelial neoplasia in cystoprostatectomy specimens. Eur Urol 39:30–31PubMedCrossRef
28.
Zurück zum Zitat Ward JF, Bartsch G, Sebo TJ, Pinggera GM, Blute ML, Zincke H (2004) Pathologic characterization of prostate cancers with a very low serum prostate specific antigen (0–2 ng/mL) incidental to cystoprostatectomy: is PSA a useful indicator of clinical significance? Urol Oncol 22:40–47PubMedCrossRef Ward JF, Bartsch G, Sebo TJ, Pinggera GM, Blute ML, Zincke H (2004) Pathologic characterization of prostate cancers with a very low serum prostate specific antigen (0–2 ng/mL) incidental to cystoprostatectomy: is PSA a useful indicator of clinical significance? Urol Oncol 22:40–47PubMedCrossRef
29.
Zurück zum Zitat Delongchamps NB, Mao K, Theng H, Zerbib M, Debre B, Peyromaure M (2005) Outcome of patients with fortuitous prostate cancer after radical cystoprostatectomy for bladder cancer. Eur Urol 48:946–950PubMedCrossRef Delongchamps NB, Mao K, Theng H, Zerbib M, Debre B, Peyromaure M (2005) Outcome of patients with fortuitous prostate cancer after radical cystoprostatectomy for bladder cancer. Eur Urol 48:946–950PubMedCrossRef
30.
Zurück zum Zitat Rocco B, de Cobelli O, Leon ME et al (2006) Sensitivity and detection rate of a 12-core transperineal prostate biopsy: preliminary report. Eur Urol 49:827–833PubMedCrossRef Rocco B, de Cobelli O, Leon ME et al (2006) Sensitivity and detection rate of a 12-core transperineal prostate biopsy: preliminary report. Eur Urol 49:827–833PubMedCrossRef
31.
Zurück zum Zitat Winkler MH, Livni N, Mannion EM, Hrouda D, Christmas T (2007) Characteristics of incidental prostatic adenocarcinoma in contemporary radical cystoprostatectomy specimens. BJU Int 99:554–558PubMedCrossRef Winkler MH, Livni N, Mannion EM, Hrouda D, Christmas T (2007) Characteristics of incidental prostatic adenocarcinoma in contemporary radical cystoprostatectomy specimens. BJU Int 99:554–558PubMedCrossRef
32.
Zurück zum Zitat Hosseini SY, Danesh AK, Parvin M et al (2007) Incidental prostatic adenocarcinoma in patients with PSA less than 4 ng/mL undergoing radical cystoprostatectomy for bladder cancer in Iranian men. Int Braz J Urol 33:167–173PubMedCrossRef Hosseini SY, Danesh AK, Parvin M et al (2007) Incidental prostatic adenocarcinoma in patients with PSA less than 4 ng/mL undergoing radical cystoprostatectomy for bladder cancer in Iranian men. Int Braz J Urol 33:167–173PubMedCrossRef
33.
Zurück zum Zitat Weizer AZ, Shah RB, Lee CT et al (2007) Evaluation of the prostate peripheral zone/capsule in patients undergoing radical cystoprostatectomy: defining risk with prostate capsule sparing cystectomy. Urol Oncol 25:460–464PubMedCrossRef Weizer AZ, Shah RB, Lee CT et al (2007) Evaluation of the prostate peripheral zone/capsule in patients undergoing radical cystoprostatectomy: defining risk with prostate capsule sparing cystectomy. Urol Oncol 25:460–464PubMedCrossRef
Metadaten
Titel
Potentially clinically relevant prostate cancer is found more frequently after complete than after partial histopathological processing of radical cystoprostatectomy specimens
verfasst von
H. M. Fritsche
A. Aziz
F. Eder
W. Otto
S. Denzinger
W. F. Wieland
M. May
F. Hofstädter
A. Hartmann
M. Burger
Publikationsdatum
01.12.2012
Verlag
Springer-Verlag
Erschienen in
Virchows Archiv / Ausgabe 6/2012
Print ISSN: 0945-6317
Elektronische ISSN: 1432-2307
DOI
https://doi.org/10.1007/s00428-012-1328-6

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