Impact of the Level of Urothelial Carcinoma Involvement of the Prostate on Survival after Radical Cystectomy
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Impact of the Level of Urothelial Carcinoma Involvement of the Prostate on Survival after Radical Cystectomy. / Moschini, Marco; Soria, Francesco; Susani, Martin; Korn, Stephan; Briganti, Alberto; Roupret, Morgan; Seitz, Christian; Gust, Killian; Haitel, Andrea; Montorsi, Francesco; Wirth, Gregory; Robinson, Brian D; Karakiewicz, Pierre I; Özsoy, Mehmet; Rink, Michael; Shariat, Shahrokh F.
In: Bladder Cancer, Vol. 3, No. 3, 27.07.2017, p. 161-169.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Impact of the Level of Urothelial Carcinoma Involvement of the Prostate on Survival after Radical Cystectomy
AU - Moschini, Marco
AU - Soria, Francesco
AU - Susani, Martin
AU - Korn, Stephan
AU - Briganti, Alberto
AU - Roupret, Morgan
AU - Seitz, Christian
AU - Gust, Killian
AU - Haitel, Andrea
AU - Montorsi, Francesco
AU - Wirth, Gregory
AU - Robinson, Brian D
AU - Karakiewicz, Pierre I
AU - Özsoy, Mehmet
AU - Rink, Michael
AU - Shariat, Shahrokh F
PY - 2017/7/27
Y1 - 2017/7/27
N2 - OBJECTIVE: Urothelial prostatic involvement (UPI) at the time of radical cystoprostatectomy (RCP) was found associated with worse survival outcomes by several previous reports. Our aim is to evaluate the impact of different levels of UPI on survival outcomes using a large series of male patients treated with RCP.METHODS: Whole step section specimens from 995 male BCa patients were assessed for UPI defined as: no involvement vs. prostatic urethral carcinomain situ(CIS) vs. lamina propria involvement vs. ductal CIS vs. prostate stromal involvement. Primary end point of the study was predictors of prostatic involvement at RCP and its impact on overall survival after surgery.RESULTS: Prostatic involvement was recorded in 307 (30.9%) patients: 28% with prostatic urethral CIS, 12% with lamina propria involvement, 13% with ductal CIS and 47% with stromal involvement. Median follow-up was 70 months. Patients with stromal involvement had a worse 5-year survival (12%) than those with prostatic urethra CIS (40%), lamina propria involvement (36%), and ductal CIS (35%). Considering predictors of prostatic involvement, multifocal tumor (Odds Ratio [OR]: 6.60,p < 0.001), lymphovascular invasion (OR: 2.61,p < 0.001), lymph node metastases (OR: 2.02,p < 0.001) and CIS (OR: 2.02,p < 0.001) were found associated. Similar predictors were found assessing stromal involvement.CONCLUSIONS: Approximately one third of RCP patients harbor prostatic involvement of urothelial carcinoma. While all UPI are associated with worse overall survival, stromal involvement confers the worst outcome supporting its classification as T4 in the TNM staging.
AB - OBJECTIVE: Urothelial prostatic involvement (UPI) at the time of radical cystoprostatectomy (RCP) was found associated with worse survival outcomes by several previous reports. Our aim is to evaluate the impact of different levels of UPI on survival outcomes using a large series of male patients treated with RCP.METHODS: Whole step section specimens from 995 male BCa patients were assessed for UPI defined as: no involvement vs. prostatic urethral carcinomain situ(CIS) vs. lamina propria involvement vs. ductal CIS vs. prostate stromal involvement. Primary end point of the study was predictors of prostatic involvement at RCP and its impact on overall survival after surgery.RESULTS: Prostatic involvement was recorded in 307 (30.9%) patients: 28% with prostatic urethral CIS, 12% with lamina propria involvement, 13% with ductal CIS and 47% with stromal involvement. Median follow-up was 70 months. Patients with stromal involvement had a worse 5-year survival (12%) than those with prostatic urethra CIS (40%), lamina propria involvement (36%), and ductal CIS (35%). Considering predictors of prostatic involvement, multifocal tumor (Odds Ratio [OR]: 6.60,p < 0.001), lymphovascular invasion (OR: 2.61,p < 0.001), lymph node metastases (OR: 2.02,p < 0.001) and CIS (OR: 2.02,p < 0.001) were found associated. Similar predictors were found assessing stromal involvement.CONCLUSIONS: Approximately one third of RCP patients harbor prostatic involvement of urothelial carcinoma. While all UPI are associated with worse overall survival, stromal involvement confers the worst outcome supporting its classification as T4 in the TNM staging.
KW - Journal Article
U2 - 10.3233/BLC-160086
DO - 10.3233/BLC-160086
M3 - SCORING: Journal article
C2 - 28824943
VL - 3
SP - 161
EP - 169
JO - Bladder Cancer
JF - Bladder Cancer
SN - 2352-3727
IS - 3
ER -