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Concomitant Gleason Score ≥7 prostate cancer is an independent prognosticator for poor survival in nonmetastatic bladder cancer patients undergoing radical cystoprostatectomy

  • Urology - Original article
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Abstract

Purpose

In bladder cancer (BCa) patients undergoing radical cystoprostatectomy (RCPx), concomitant prostate cancer (PCa) is a common finding. Up to now there is no clear evidence to suggest that concomitant PCa is a predictor of outcome in these patients. Aim of this study was to assess incidence and clinicopathologic characteristics of concomitant PCa in RCPx specimen and correlate it to survival parameters from a single-centre material over two decades.

Methods

All men who had undergone RCPx for BCa at our institution between 1994 and 2013 were included in this study. Clinicopathologic parameters for BCa and PCa were evaluated and correlated with outcome parameters. Survival analysis was performed for the subgroup of nonmetastatic organ-confined BCa to evaluate the role of concomitant Gleason Score (GS) ≥7 PCa.

Results

Of 945 men who had undergone RCPx for BCa, concomitant PCa was present in 237 patients (25.1 %). There was a significant increase in PCa incidence from 18.9 to 32.3 % between 1994 and 2013 (p = 0.009). Concomitant PCa represented a more aggressive phenotype at the end of the study (p = 0.037). In nonmetastatic organ-confined BCa, concomitant GS ≥7 PCa (HR 3.09; p = 0.0001) and age > 68 (HR 1.80; p = 0.0004) were independent negative predictors for overall survival.

Conclusions

Concomitant PCa in RCPx specimen of BCa patients is a common finding. The incidence of concomitant PCa has significantly increased within 2 decades, presenting a more aggressive phenotype. Age and in particular concomitant GS ≥7 PCa are independent prognosticators for poor survival in patients with nonmetastatic organ-confined BCa.

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Abbreviations

BCa:

Bladder cancer

GS:

Gleason Score

HR:

Hazard ratio

ICR:

Interquartile range

OS:

Overall survival

PCa:

Prostate cancer

RCPx:

Radical cystoprostatectomy

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Acknowledgments

This study is part of the doctoral thesis of Alexander Giesswein. We thank Lara Ermer, Katharina Sprigade and Annika Miller for their support in data acquisition.

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    Authors and Affiliations

    1. Department of Urology, University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany

      Christian Thomas, Alexander Giesswein, Raimund Stein, Peter Rubenwolf, Frederik C. Roos, Andreas Neisius, Sebastian Nestler, Christian Hampel, Wolfgang Jäger, Christoph Wiesner & Joachim W. Thüroff

    2. Department of Pathology, University of Mainz, Mainz, Germany

      Michael Hainz

    3. Department of Urology, KRH Hospital Siloah-Oststadt-Heidehaus, Hannover, Germany

      Christoph Wiesner

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    1. Christian Thomas
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    2. Alexander Giesswein
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    Corresponding author

    Correspondence to Christian Thomas.

    Additional information

    Christoph Wiesner and Joachim W. Thüroff have contributed equally to this work.

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    Thomas, C., Giesswein, A., Hainz, M. et al. Concomitant Gleason Score ≥7 prostate cancer is an independent prognosticator for poor survival in nonmetastatic bladder cancer patients undergoing radical cystoprostatectomy. Int Urol Nephrol 47, 1789–1796 (2015). https://doi.org/10.1007/s11255-015-1110-1

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    • DOI: https://doi.org/10.1007/s11255-015-1110-1

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