Incidence and prognosis of clinically significant incidental prostate cancer after radical cystectomy for bladder cancer.

Objective: To evaluate the prevalence and significance of incidental prostate cancer in patients after radical cystectomy for bladder cancer, as well as its impact in terms of overall survival and biochemical recurrence.

Methods: Patients with bladder cancer treated with radical cystectomy in our hospital between 1998 and 2014 were included in the study. None of the patients had previous history of prostatic adenocarcinoma. Complete embedding of the prostate gland as whole mount serial section of the radical cystectomy specimens was done.

Results: 180 patients were included. The mean age was 69.71 years with a median follow-up of 34.2 months. Three groups were analyzed: non-incidental prostate cancer (n=136), non-significant incidental prostate cancer (n=28) and significant incidental prostate cancer (n=16). During follow-up, 50 patients (27.78%) died from bladder cancer. There were no differences in overall survival between patients with or without prostate cancer, neither between patients with significant nor insignificant prostate cancer in the radical cystectomy specimens. Biochemical recurrence was not observed in any patient.

Conclusions: Incidental prostate cancer had a higher prevalence than previously expected in our cohort (24.4%), but it had no impact in overall survival of patients not even in those with a significant prostate cancer. No biochemical recurrence was reported during the study.