Evaluation of the prostate peripheral zone/capsule in patients undergoing radical cystoprostatectomy: Defining risk with prostate capsule sparing cystectomy

Alon Z. Weizer, Rajal B. Shah, Cheryl T. Lee, Scott M. Gilbert, Stephanie Daignault, James E. Montie, David P. Wood

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Objectives: Prostate capsule sparing cystectomy has been performed in conjunction with orthotopic diversion to preserve sexual function and improve urinary control. Because concerns remain regarding incomplete surgical resection, we evaluated the risk of urothelial and prostate cancer in a series of patients undergoing radical cystoprostatectomy. Methods: A total of 35 men undergoing radical cystoprostatectomy (August 2003-August 2005) had separate submission of the prostate peripheral zone/capsule from the prostate adenoma and bladder after surgery. These specimens were evaluated for bladder and prostate cancer grade, stage, and largest diameter of prostate cancer. Patient records were reviewed for demographic and medical information. Clinical variables were compared between patients with and without carcinoma involving the prostate using standard statistical software. Results: Of patients, 57% had cancer involving the prostate at radical cystoprostatectomy. There were 9 patients (26%) who had urothelial carcinoma involving the prostate; only prostatic urethral biopsy identified these patients before radical cystoprostatectomy. Prostate adenocarcinoma was evident in 16 of 35 (47%) patients, with a majority involving the prostate peripheral zone/capsule (43%). There were 4 patients (11%) who had clinically significant prostate cancer (Gleason sum >6 or tumor volume >0.5 cm3). Patients with prostate cancer were significantly older than patients without prostate cancer (P = 0.01). Conclusions: No clinical variable can confidently predict patients with prostate cancer involving the prostate. Because a majority of patients undergoing radical cystoprostatectomy have cancer involving their prostate, preoperative evaluation with prostatic urethral and prostate biopsy may be useful to guide patient selection for prostate capsule sparing cystectomy.

Original languageEnglish (US)
Pages (from-to)460-464
Number of pages5
JournalUrologic Oncology: Seminars and Original Investigations
Volume25
Issue number6
DOIs
Publication statusPublished - Nov 1 2007
Externally publishedYes

    Fingerprint

Keywords

  • Bladder neoplasms
  • Cystectomy
  • Prostate
  • Prostatic neoplasms
  • Urinary incontinence

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this