2054 CHARACTERISTICS OF PROSTATE CANCERS FOUND IN SPECIMENS REMOVED BY RADICAL CYSTOPROSTATECTOMY FOR BLADDER CANCER AND THEIR RELATIONSHIP WITH SERUM PROSTATE-SPECIFIC ANTIGEN LEVEL (2010)

You have accessJournal of UrologyProstate Cancer: Markers I1 Apr 20102054 CHARACTERISTICS OF PROSTATE CANCERS FOUND IN SPECIMENS REMOVED BY RADICAL CYSTOPROSTATECTOMY FOR BLADDER CANCER AND THEIR RELATIONSHIP WITH SERUM PROSTATE-SPECIFIC ANTIGEN LEVEL Tohru Nakagawa, Yae Kanai, Motokiyo Komiyama, Hiroyuki Fujimoto, and Tadao Kakizoe Tohru NakagawaTohru Nakagawa More articles by this author , Yae KanaiYae Kanai More articles by this author , Motokiyo KomiyamaMotokiyo Komiyama More articles by this author , Hiroyuki FujimotoHiroyuki Fujimoto More articles by this author , and Tadao KakizoeTadao Kakizoe More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2101AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate cancer mass screening using serum prostate-specific antigen (PSA) has been conducted widely in the world. However, little has been known about the true prevalence of prostate cancer in the ″normal″ PSA range (4.0 ng/ml or less). The aim of the present study was to elucidate the clinicopathological features of prostate cancer occurring in men with a wide range of PSA levels. METHODS The study comprised 349 male patients who underwent radical cystoprostatectomy for bladder cancer. Patients who had had treatment for known prostate cancer were excluded. Tissue specimens were reviewed microscopically. Prostate cancer was considered clinically significant if any of the following criteria were present: total tumor volume ≥0.5 mL, Gleason grade ≥4, extracapsular extension, seminal vesicle invasion, or lymph node metastasis. RESULTS Median patient age was 65 (range, 27-89) years. The median preoperative PSA level was 1.28 ng/ml (range, 0.03-20.603). Ninety-one patients (26.1%) were found to have prostate cancer, and 68 (74.7%) of these 91 cancers were considered to be clinically significant. The pathological features of these 91 prostate cancers were as follows; Gleason score 6 or less / 7 (3+4) / 7 (4+3) / 8 or more = 24 / 54 / 9 / 4, pT2 / pT3a / pT3b / pT4 = 85 / 3 / 1 / 2, pN0 / pN1 / pN2 = 89 / 1 / 1. Larger cancers were more likely to have a higher Gleason score and to have lymph node metastasis. Both increasing patient age and PSA level were significantly correlated with an increased incidence of both all and significant prostate cancers. Sixty-five (21.9%) among 297 patients with PSA <4.0 ng/ml had prostate cancer, and 45 (69.2%) of the 65 cancers were significant cancers. Eighteen patients had prostate cancers 0.5 ml or more in volume. Among the 18 patients, the PSA level was 4 ng/ml or more in 11, and 3 ng/ml or more in 15. CONCLUSIONS Our study shows that prostate cancer is a common finding in radical cystoprostatectomy specimens excised because of bladder cancers, and a significant proportion of these cancers are clinically significant. PSA still appears to be a useful screening tool for detecting prostate cancers with significant volume. Tokyo, Japan© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e798-e799 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tohru Nakagawa More articles by this author Yae Kanai More articles by this author Motokiyo Komiyama More articles by this author Hiroyuki Fujimoto More articles by this author Tadao Kakizoe More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...