Prostate and Bladder Cancer Coexistence in Patients Undergoing Radical Cystoprostatectomy

BACKGROUND: According to the Polish National Cancer Registry, bladder cancer is the 4th most common cancer in the male population (7.0%), while prostate cancer takes 2nd place (14.0%). In the case of both cancer types, prognoses are precarious and depend on many factors, such as the size of the primary tumor, infiltration of regional lymph nodes, histological grade and occurrence of distant metastases. OBJECTIVES: The objective of this work is to verify the coincidence of prostate cancer and bladder cancer in patients who underwent radical cystoprostatectomy in Wroclaw Medical University, Department of Urology and Oncological Urology, as well as to indicate factors that may influence the peri- and post-operative course. MATERIAL AND METHODS: We have retrospectively reviewed patients who underwent radical cystoprostatectomy for muscular-invasive bladder cancer between 2009 and 2014, which comprised of 116 male patients. We managed to establish telephone and personal contact with the patients. RESULTS: Seventeen of the 116 patients were diagnosed with coincidental prostate cancer in post-operative histological examination (14.6%). This result is lower than in other series of cystoprostatectomy cases (range 23-68%). The mean age of patient was 68.9 years and the median was 69.5 years. Factors influencing the peri- and post-operative periods were not statistically significant. CONCLUSIONS: Serum PSA level and DRE should be performed more often on patients prepared for radical cystoprostatectomy. An accurate pre-operative assessment of cancer infiltration is required for both types of tumors. Complete resection of prostate prevents residual neoplasm infiltration. It is important to take into account the possibility of primary prostate tumor occurrence in patients qualified for radical cystectomy. The post-operative supervision should be focused not only on bladder carcinoma but on the prostate carcinoma, too.