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Evaluation of the residual prostate cancer rate on cystoprostatectomy specimen in patients treated with radiotherapy for prostate cancer

  • Urology - Original Paper
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Abstract

Purpose

To evaluate the residual cancer rate after cystoprostatectomy (CPT) in patients with a history of radiation therapy for prostate cancer and the postoperative complication rates.

Material and methods

We conducted a retrospective study involving 21 patients who had a CPT over 7 years and who had a history of radiotherapy for prostate cancer. To compare results, two additional groups were created: a group of patients without a history of radiotherapy in whom a CPT was performed, and a group without a history of radiotherapy and in whom was accidentally discovered a prostate cancer after CPT on histology specimens.

Results

The median age at the time of radiotherapy was 69 years. The median age at the time of cystoprostatectomy was 78 years. The median PSA at the time of the intervention was 0.6 ng/ml in the group with a history of radiotherapy. The residual cancer rate was 24%. No patients had criteria for biological recurrence. There were no additional surgical complications in the radiotherapy group (p = 0.2). The rate of cutaneous ureterostomy was higher (p = 0.0006) due to increased surgical difficulties (p = 0.0009).

Conclusion

The residual cancer rate was 24% after radiotherapy for prostate cancer. PSA alone does not appear to be sufficient to detect the persistence of residual prostate cancer after radiotherapy. There were no more surgical complications after prostate radiotherapy.

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References

  1. Schröder FH, Hugosson J, Roobol MJ, Tammela TLJ, Zappa M, Nelen V et al (2014) Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet 384:2027–2035

    Article  Google Scholar 

  2. Arnsrud Godtman R, Holmberg E, Lilja H, Stranne J, Hugosson J (2015) Opportunistic testing versus organized prostate-specific antigen screening: outcome after 18 years in the Göteborg randomized population-based prostate cancer screening trial. Eur Urol 68:354–360

    Article  Google Scholar 

  3. Zelefsky MJ, Leibel SA, Gaudin PB, Kutcher GJ, Fleshner NE, Venkatramen ES et al (1998) Dose escalation with three-dimensional conformal radiation therapy affects the outcome in prostate cancer. Int J Radiat Oncol Biol Phys 41:491–500

    Article  CAS  Google Scholar 

  4. Kaplan DJ, Crispen PL, Greenberg RE, Chen DYT, Viterbo R, Buyyounouski MK et al (2008) Residual prostate cancer after radiotherapy: a study of radical cystoprostatectomy specimens. Urology 72:654–658

    Article  Google Scholar 

  5. Meeks JJ, Kern SQ, Dalbagni G, Eastham JA, Sandhu JS (2014) The prevalence of persistent prostate cancer after radiotherapy detected at radical cystoprostatectomy for bladder cancer. J Urol 191:1760–1763

    Article  Google Scholar 

  6. Magi-Galluzzi C, Sanderson H, Epstein JI (2003) Atypia in nonneoplastic prostate glands after radiotherapy for prostate cancer: duration of atypia and relation to type of radiotherapy. Am J Surg Pathol 27:206–212

    Article  Google Scholar 

  7. Cheng L, Cheville JC, Bostwick DG (1999) Diagnosis of prostate cancer in needle biopsies after radiation therapy. Am J Surg Pathol 23:1173–1183

    Article  CAS  Google Scholar 

  8. Vance W, Tucker SL, de Crevoisier R, Kuban DA, Cheung MR (2007) The predictive value of 2-year posttreatment biopsy after prostate cancer radiotherapy for eventual biochemical outcome. Int J Radiat Oncol Biol Phys 67:828–833

    Article  Google Scholar 

  9. Chaiswing L, Weiss HL, Jayswal RD, St. Clair DK, Kyprianou N (2018) Profiles of radioresistance mechanisms in prostate cancer. Crit Rev Oncog 23:39–67

    Article  Google Scholar 

  10. Wallis CJD, Mahar AL, Choo R, Herschorn S, Kodama RT, Shah PS et al (2016) Second malignancies after radiotherapy for prostate cancer: systematic review and meta-analysis. BMJ 352:i851

    Article  Google Scholar 

  11. Rolland E, Bitker M-O, Richard F (2007) Radiation-induced tumours after irradiation for localized prostate cancer: review and proposals for long-term follow-up. Prog Urol 17:1302–1304

    Article  Google Scholar 

  12. Moschini M, Zaffuto E, Karakiewicz PI, Andrea DD, Foerster B, Abufaraj M et al (2019) External beam radiotherapy increases the risk of bladder cancer when compared with radical prostatectomy in patients affected by prostate cancer: a population-based analysis. Eur Urol 75:319–328

    Article  Google Scholar 

  13. Wang C, King CR, Kamrava M, Iwamoto KS, Chen AM, Low D et al (2017) Pattern of solid and hematopoietic second malignancy after local therapy for prostate cancer. Radiother Oncol 123:133–138

    Article  Google Scholar 

  14. Abern MR, Dude AM, Tsivian M, Coogan CL (2013) The characteristics of bladder cancer after radiotherapy for prostate cancer. Urol Oncol 31:1628–1634

    Article  Google Scholar 

  15. Svare J, Walter S, Kvist Kristensen J, Lund F (1985) Ileal conduit urinary diversion—early and late complications. Eur Urol 11:83–86

    Article  CAS  Google Scholar 

  16. Wrigley JV, Prem KA, Fraley EE (1976) Pelvic exenteration: complications of urinary diversion. J Urol 116:428–430

    Article  CAS  Google Scholar 

  17. Skinner DG, Crawford ED, Kaufman JJ (1980) Complications of radical cystectomy for carcinoma of the bladder. J Urol 123:640–643

    Article  CAS  Google Scholar 

  18. Sullivan JW, Grabstald H, Whitmore WF (1980) Complications of ureteroileal conduit with radical cystectomy: review of 336 cases. J Urol 124:797–801

    Article  CAS  Google Scholar 

  19. Pepe P, Fraggetta F, Galia A, Panella P, Pennisi M, Colecchia M, Aragona F (2014) Preoperative findings, pathological satge PSA recurrence in men with prostate cancer incidentally detected at radical cystectomy: our experience in 242 cases. Int Urol Nephrol 46:1325–1328

    Article  Google Scholar 

  20. Pignot G, Salomon L, Lebacle C, Neuzillet Y, Lunardi P, Rischmann P et al (2015) Prostate cancer incidence on cystoprostatectomy specimens is directly linked to age: results from a multicentre study. BJU Int 115:87–93

    Article  Google Scholar 

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Acknowledgements

Dr. Sylvie Collon for English wording corrections.

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Correspondence to Xavier Tillou.

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Authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Schlegel, J., Chahwan, C., Ait Said, K. et al. Evaluation of the residual prostate cancer rate on cystoprostatectomy specimen in patients treated with radiotherapy for prostate cancer. Int Urol Nephrol 52, 279–285 (2020). https://doi.org/10.1007/s11255-019-02312-0

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