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Oh WJ, Chung AM, Kim JS, Han JH, Hong SH, Lee JY, Choi YJ. Differential Immunohistochemical Profiles for Distinguishing Prostate Carcinoma and Urothelial Carcinoma. J Pathol Transl Med 2016; 50:345-54. [PMID: 27498545 PMCID: PMC5042899 DOI: 10.4132/jptm.2016.06.14] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 05/21/2016] [Accepted: 06/14/2016] [Indexed: 11/26/2022] Open
Abstract
Background The pathologic distinction between high-grade prostate adenocarcinoma (PAC) involving the urinary bladder and high-grade urothelial carcinoma (UC) infiltrating the prostate can be difficult. However, making this distinction is clinically important because of the different treatment modalities for these two entities. Methods A total of 249 patient cases (PAC, 111 cases; UC, 138 cases) collected between June 1995 and July 2009 at Seoul St. Mary’s Hospital were studied. An immunohistochemical evaluation of prostatic markers (prostate-specific antigen [PSA], prostate-specific membrane antigen [PSMA], prostate acid phosphatase [PAP], P501s, NKX3.1, and α-methylacyl coenzyme A racemase [AMACR]) and urothelial markers (CK34βE12, p63, thrombomodulin, S100P, and GATA binding protein 3 [GATA3]) was performed using tissue microarrays from each tumor. Results The sensitivities of prostatic markers in PAC were 100% for PSA, 83.8% for PSMA, 91.9% for PAP, 93.7% for P501s, 88.3% for NKX 3.1, and 66.7% for AMACR. However, the urothelial markers CK34βE12, p63, thrombomodulin, S100P, and GATA3 were also positive in 1.8%, 0%, 0%, 3.6%, and 0% of PAC, respectively. The sensitivities of urothelial markers in UC were 75.4% for CK34βE12, 73.9% for p63, 45.7% for thrombomodulin, 22.5% for S100P, and 84.8% for GATA3. Conversely, the prostatic markers PSA, PSMA, PAP, P501s, NKX3.1, and AMACR were also positive in 9.4%, 0.7%, 18.8%, 0.7%, 0%, and 8.7% of UCs, respectively. Conclusions Prostatic and urothelial markers, including PSA, NKX3.1, p63, thrombomodulin, and GATA3 are very useful for differentiating PAC from UC. The optimal combination of prostatic and urothelial markers could improve the ability to differentiate PAC from UC pathologically.
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Affiliation(s)
- Woo Jin Oh
- Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Arthur Minwoo Chung
- Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jee Soon Kim
- Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Heun Han
- Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Hoo Hong
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Yeol Lee
- Department of Urology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yeong Jin Choi
- Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Palou J, Wood D, Bochner BH, van der Poel H, Al-Ahmadie HA, Yossepowitch O, Soloway MS, Jenkins LC. ICUD-EAU International Consultation on Bladder Cancer 2012: Urothelial Carcinoma of the Prostate. Eur Urol 2013; 63:81-7. [DOI: 10.1016/j.eururo.2012.08.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Accepted: 08/06/2012] [Indexed: 11/30/2022]
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Lerner SP, Shen S. Pathologic assessment and clinical significance of prostatic involvement by transitional cell carcinoma and prostate cancer. Urol Oncol 2008; 26:481-5. [PMID: 18774459 DOI: 10.1016/j.urolonc.2008.03.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The prostate is commonly involved by transitional cell carcinoma (TCC) in patients with bladder cancer. A number of clinicopathologic factors including multifocal carcinoma in situ, tumor location, and tumor stage are associated with prostatic TCC (pTCC). In addition, the manner and extent of pathologic examination also makes a significant difference in the detection rate. Distinct patterns and extent of pTCC have been described and are associated with pathologic stage of the primary bladder tumor as well as prognosis. Preoperative transurethral biopsy of the prostatic urethra is a sensitive and accurate method to detect pTCC and is helpful for surgical planning. Given the high incidence of pTCC and prostatic adenocarcinoma, radical cystoprostatectomy is the treatment of choice for loco-regional control for patients with T4a disease. Further studies are necessary to establish the role of neoadjuvant and adjuvant therapy for patient with prostatic stroma invasion.
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Affiliation(s)
- Seth P Lerner
- Scott Department of Urology, Baylor College of Medicine, and Department of Pathology, The Methodist Hospital, Houston, TX 77030, USA.
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Shen SS, Lerner SP. Prostatic transitional cell carcinoma: pathologic features and clinical management. Expert Rev Anticancer Ther 2007; 7:1155-62. [PMID: 18028024 DOI: 10.1586/14737140.7.8.1155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Prostatic involvement by transitional cell carcinoma (pTCC) in patients with bladder cancer is a frequent finding, particularly in patients with high-grade invasive tumor and urothelial carcinoma in situ. Various patterns and levels of prostatic involvement have been described, and their impact in patients' management and their prognosis recognized. The role of prostatic urethral biopsy and intraoperative frozen section in the management of bladder cancer, tailoring to the bladder tumor stage is still not well defined and universally accepted. This review discusses the current understanding of the biology and histological patterns of pTCC and their clinical significance and management options. A rational approach for management of pTCC in patients with bladder cancer will be proposed on the basis of our experience and our review of literature.
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Affiliation(s)
- Steven S Shen
- Department of Pathology, The Methodist Hospital and Weill Medical College of Cornell University, 6565 Fannin Street, Houston, TX 77030, USA.
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Palou J, Baniel J, Klotz L, Wood D, Cookson M, Lerner S, Horie S, Schoenberg M, Angulo J, Bassi P. Urothelial Carcinoma of the Prostate. Urology 2007; 69:50-61. [PMID: 17280908 DOI: 10.1016/j.urology.2006.05.059] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2006] [Revised: 04/05/2006] [Accepted: 05/03/2006] [Indexed: 10/23/2022]
Abstract
This study was conducted to explore the diagnosis and management of urothelial carcinoma of the prostate in superficial disease and carcinoma in situ, stromal invasion, primary urothelial carcinoma, and urethral recurrence after radical surgery. A consensus conference convened by the World Health Organization (WHO) and the Société Internationale d'Urologie (SIU) reviewed the diagnosis and management of urothelial carcinoma of the bladder. English-language literature about urothelial carcinoma of the prostate was identified and reviewed. Evidence-based recommendations for the diagnosis and management of urothelial carcinoma were made. Many recommendations were level 3 or 4 citations involving the diagnosis and management of superficial urothelial carcinoma; a few were level 2 citations. Level 1 citations related only to chemotherapy and radiotherapy in patients with stromal invasion, although these were not related specifically to invasive prostatic involvement. More than 130 reviewed citations are summarized in this review. Published reports on the diagnosis and treatment of superficial urothelial disease of the prostate primarily consist of short case series from individual centers. Prospective and multicenter trials are needed to identify the real incidence and the best management of these patients. In invasive disease of the prostate, the only large series were designed to investigate invasive bladder cancer.
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Affiliation(s)
- Juan Palou
- Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Palou Redorta J, Schatteman P, Huguet Pérez J, Segarra Tomás J, Rosales Bordes A, Algaba F, Villavicencio Mavrich H. Intravesical Instillations with Bacillus Calmette-Guérin for the Treatment of Carcinoma In Situ Involving Prostatic Ducts. Eur Urol 2006; 49:834-8; discussion 838. [PMID: 16426729 DOI: 10.1016/j.eururo.2005.12.019] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2005] [Revised: 12/06/2005] [Accepted: 12/12/2005] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Bacillus Calmette-Guérin (BCG) has proven its efficacy in the treatment of carcinoma in situ (CIS) of the prostatic urethra. We performed a retrospective study to evaluate the use of intravesical instillations of BCG in patients with carcinoma in situ involving prostatic ducts after complete transurethral resection (TUR). MATERIAL AND METHODS Eligibility for the study was CIS of the prostatic urethra involving prostatic ducts. Previous instillation with BCG was an exclusion criterion. Patients were treated with intravesical BCG Connaught (81 mg) administered once a week, over a 6-wk period. TUR loop biopsies of the prostate were performed only when a macroscopic tumor was present. RESULTS In this retrospective study of 11 patients, 8 (73%) presented with macroscopic tumor in the prostatic urethra. Ten patients (91%) had a simultaneous superficial bladder carcinoma. Eight patients (73%) had tumoral involvement of the bladder neck region. After a median follow-up of 27 mo (n=10 patients), the response in the prostatic urethra was 82%, and the response in the bladder due to superficial tumor recurrence was 64%. Two patients with residual ductal disease in the prostatic urethra were subsequently treated with cystoprostatectomy and are currently free of disease. In one of those patients, the cystoprostatectomy specimen did show prostatic stromal invasion. Another patient developed distant metastatic disease and died a few months after diagnosis. Thus, progression was encountered in two patients (18%). Currently, 90% of patients are alive without evidence of disease and 72.7% have benefitted from this bladder preservation strategy. CONCLUSION Intravesical BCG is a feasible treatment option for patients with CIS involving prostatic ducts. In this retrospective study, bladder preservation was successful in 8 of 11 patients (70%) and there was only one oncologic death. Obviously, these patients need a careful follow-up with cystoscopy and cytology to detect either recurrence or progression and in those with persistent disease after the initial BCG induction therapy, prompt cystectomy is indicated.
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Honda N, Yamada Y, Okada M, Aoki S, Kamijyo A, Taki T, Mitsui K, Hibi H, Fukatsu H. Clinical study of transitional cell carcinoma of the prostate associated with bladder transitional cell carcinoma. Int J Urol 2001; 8:662-8. [PMID: 11851765 DOI: 10.1046/j.1442-2042.2001.00394.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Transitional cell carcinoma of the prostate in patients with bladder cancer appears to influence the prognosis and affects the decision about therapeutic modality. Therefore, it is important to characterize transitional cell carcinoma associated with bladder cancer. METHODS From April 1980 to December 1998, 81 male patients underwent total cystoprostatectomies for transitional cell carcinoma of the bladder. The 81 cystoprostatectomy specimens were examined to clarify the characteristics of prostatic involvement by transitional cell carcinoma. The extent, origin, mode of spread and risk factor of prostatic involvement as well as the prognosis were investigated. In 13 of 15 patients with prostatic involvement the prostate was examined by sequential step sections. RESULTS Prostatic involvement was observed in 15 of 81 patients (18.5%). Prostatic urethral involvement, invasion to prostatic duct/acinus, prostatic stromal invasion and extraprostatic extension and/or seminal vesicle involvement were recognized in 12 (80%), 14 (93.3%), six (40%), and five (33.3%) of the 15 patients, respectively. Twelve of the 15 patients (80%) with prostatic involvement had papillary or non-papillary tumors (i.e. carcinoma in situ) both in the prostatic urethra and prostatic duct. In 10 of these 12 patients (88.3%), there was contiguity between prostatic urethral and ductal tumors. Seven of the 23 patients (30.4%) with carcinoma in situ of the bladder showed prostatic involvement, which increased to 50% in the presence of carcinoma in situ of the trigone or bladder neck. CONCLUSIONS Eighty per cent of the patients with prostatic involvement showed papillary or non-papillary tumors both in the prostatic urethra and prostatic duct. There was a high level of contiguity between both tumors. Patients with carcinoma in situ of the trigone or bladder neck revealed significantly higher incidence of prostatic involvement.
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Affiliation(s)
- N Honda
- Department of Urology, Aichi Medical University School of Medicine, Nagakute, Japan.
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DONAT SMACHELE, GENEGA ELIZABETHM, HERR HARRYW, REUTER VICTORE. MECHANISMS OF PROSTATIC STROMAL INVASION IN PATIENTS WITH BLADDER CANCER: CLINICAL SIGNIFICANCE. J Urol 2001. [DOI: 10.1016/s0022-5347(05)66441-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- S. MACHELE DONAT
- From the Departments of Urology and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - ELIZABETH M. GENEGA
- From the Departments of Urology and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - HARRY W. HERR
- From the Departments of Urology and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - VICTOR E. REUTER
- From the Departments of Urology and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York
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MECHANISMS OF PROSTATIC STROMAL INVASION IN PATIENTS WITH BLADDER CANCER: CLINICAL SIGNIFICANCE. J Urol 2001. [DOI: 10.1097/00005392-200104000-00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Varo Solís C, Soto Delgado M, Hens Pérez A, Estudillo González F, Sánchez Bernal C, González Moreno D, Maximiano Vázquez R. [Transitional carcinoma of the prostate]. Actas Urol Esp 1999; 23:806-10. [PMID: 10608069 DOI: 10.1016/s0210-4806(99)72376-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Case report of prostate transitional carcinoma diagnosed by transurethral resection, an infrequent tumour with incidence ranging from 1% to 4% of all prostate neoplasias which appears in 2.8% of all radical cystoprostatectomies specimens carried out at the Mayo Clinic. Most commonly, when it appears in the prostate this tumour is simultaneous or subsequent to other transitional carcinoma arisen in other organs mostly the bladder. Very rarely it occurs as an early form within the ducts and even less often within the prostate acinus. Review of the neoplasia histology, signs and symptoms, diagnostic procedures and management, emphasising the aggressiveness of its behaviour (such as in our case report) when the prostate gland stroma is infiltrated by the tumour.
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Affiliation(s)
- C Varo Solís
- Servicio de Urología, Hospital Universitario de Puerto Real, Cádiz
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11
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Ohtsuki Y, Mackay B, Ro JY, Ayala AG. Ribosome-lamella complexes in a case of transitional cell carcinoma involving the prostate. Med Mol Morphol 1998. [DOI: 10.1007/bf01545705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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12
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Harnden P, Parkinson M. Transitional cell carcinoma of the bladder: diagnosis and prognosis. ACTA ACUST UNITED AC 1996. [DOI: 10.1016/s0968-6053(96)80014-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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13
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Palou J, Xavier B, Laguna P, Montlleó M, Vicente J. In situ transitional cell carcinoma involvement of prostatic urethra: bacillus Calmette-Guérin therapy without previous transurethral resection of the prostate. Urology 1996; 47:482-4. [PMID: 8638354 DOI: 10.1016/s0090-4295(99)80481-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Bacillus Calmette-Guérin (BCG) has demonstrated both the efficacy in patients with carcinoma in situ (CIS) of the bladder and the penetration in the prostate (granulomas) after endovesical treatment. We treated patients with CIS of the prostatic urethra with bladder instillations of BCG without previous transurethral resection to assess the local therapeutic effect. METHODS Eighteen patients with CIS of the prostatic urethra (15 multifocal CIS and 15 associated to superficial bladder carcinoma) were treated with endovesical instillations of 81 mg of BCG Connaught weekly for 6 weeks. RESULTS After a mean follow-up of 31 months, 14 of 18 patients had complete response, 3 had progression (2 in the prostate and 1 in the bladder); diffuse CIS of the bladder persisted in 1 patient. Three patients required cystectomy and 1 underwent palliative transurethral resection. Fifteen patients are alive with no evidence of disease, 2 patients died due to progression of the disease, and 1 is alive with tumor. CONCLUSIONS The presence of CIS in the prostatic urethra can be managed with endovesical BCG as initial treatment with fairly good success. There is no need for transurethral resection, even though a loop biopsy may have to be obtained at the first control examination to make sure there is no stromal invasion.
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Affiliation(s)
- J Palou
- Department of Urology, Fundación Puigvert, Universitat Autònoma de Barcelona, Spain
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14
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The Prostate Involvement As Prognostic Factor in Patients with Superficial Bladder Tumors. J Urol 1995. [DOI: 10.1097/00005392-199511000-00033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Solsona E, Iborra I, Ricos J, Monros J, Casanova J, Almenar S. The Prostate Involvement As Prognostic Factor in Patients with Superficial Bladder Tumors. J Urol 1995. [DOI: 10.1016/s0022-5347(01)66762-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- E. Solsona
- Departments of Urology and Pathology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - I. Iborra
- Departments of Urology and Pathology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - J.V. Ricos
- Departments of Urology and Pathology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - J.L. Monros
- Departments of Urology and Pathology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - J.L. Casanova
- Departments of Urology and Pathology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - S. Almenar
- Departments of Urology and Pathology, Instituto Valenciano de Oncologia, Valencia, Spain
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Kurth KH, Schellhammer PF, Okajima E, Akdas A, Jakse G, Herr HW, Calais da Silva F, Fukushima S, Nagayama T. Current methods of assessing and treating carcinoma in situ of the bladder with or without involvement of the prostatic urethra. Int J Urol 1995; 2 Suppl 2:8-22. [PMID: 7553309 DOI: 10.1111/j.1442-2042.1995.tb00475.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- K H Kurth
- AMC Department of Urology, Amsterdam, The Netherlands
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c KHK, cc PFS, cc EO, Akdas A, Jakse G, Hen HW, Silva FCD, Fukushima S, Nagayama T. CURRENT METHODS OF ASSESSING AND TREATING CARCINOMA IN SITUOF THE BLADDER WITH OR WITHOUT INVOLVEMENT OF THE PROSTATIC URETHRA. Int J Urol 1995. [DOI: 10.1111/j.1442-2042.1995.tb00068.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Schellhammer PF, Ladaga LE, Moriarty RP. Intravesical bacillus Calmette-Guerin for the treatment of superficial transitional cell carcinoma of the prostatic urethra in association with carcinoma of the bladder. J Urol 1995; 153:53-6. [PMID: 7966790 DOI: 10.1097/00005392-199501000-00020] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Between 1981 and 1989, 83 male patients with stages Ta, Tis and T1 transitional cell carcinoma were treated with bacillus Calmette-Guerin (BCG). Of 17 patients with carcinoma in situ of the prostatic urothelium 13 had identifiable prostatic ducts and periurethral ductal transitional cell carcinoma was identified in 7. At a median followup of 64 months (range 29 to 90) 12 of 17 patients (70%) had a complete response in the prostatic urethra. Among the 10 patients with mucosal carcinoma without ductal involvement 8 responded as did 4 of the 7 with mucosal and ductal involvement. A total of 9 patients had persistent tumor or recurrence in the bladder or prostate. Two men had recurrence in the prostatic urethra and, due to age and co-morbidity, both were treated by transurethral resection and fulguration. Cystectomy was performed in the remaining 7 patients. Three of 31 patients (10%) whose prostate urethral biopsies were negative before BCG therapy had a positive biopsy afterwards. After treatment with BCG, the actuarial curves for cancer specific, progression-free and overall survivals showed no statistical difference between male patients with an initially positive or initially negative prostatic urethral biopsy. BCG is a reliable agent for initial therapy of superficial prostatic transitional cell carcinoma. Careful followup can identify persistent tumor, recurrences or progression that identifies patients for whom cystectomy is appropriate.
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Sakamoto N, Tsuneyoshi M, Naito S, Kumazawa J. An adequate sampling of the prostate to identify prostatic involvement by urothelial carcinoma in bladder cancer patients. J Urol 1993; 149:318-21. [PMID: 8426410 DOI: 10.1016/s0022-5347(17)36068-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The distribution of any involved prostatic urethra, ducts and acini by urothelial carcinoma was studied to determine an adequate sampling method for detecting prostatic involvement using the maps of 38 cystoprostatectomy specimens. A total of 31 patients had prostatic duct and acini involvement, while 7 had prostatic urethral involvement alone. However, the distribution of the involved prostatic urethra, ducts and acini varied. In 29 of the 31 patients (93.5%) with prostatic duct and acini involvement, urethral carcinoma in situ and/or superficial gland involvement (an involvement of the afferent ducts within a few millimeters of the urethral mucosa) at the 5 and/or 7 o'clock position of the verumontanum portion was identified. In 7 patients with prostatic urethral involvement alone 2 had carcinoma foci at the 5 and/or 7 o'clock position of the verumontanum portion. Furthermore, the frequency of deeper gland involvement (an involvement of true prostatic acini except for superficial glands) was higher in patients with superficial gland involvement at the 5 and/or 7 o'clock position of the verumontanum portion (57.7%) than in patients without such involvement (20.0%). Therefore, this study emphasizes that a transurethral resection biopsy containing prostatic tissue at the 5 and/or 7 o'clock position of the verumontanum portion substantially improves the detection of prostatic duct and acini involvement in bladder cancer patients. Moreover, if the prostatic superficial glands are involved at the 5 and/or 7 o'clock position of the verumontanum portion, the potential involvement of the deeper glands should also be suspected.
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Affiliation(s)
- N Sakamoto
- Second Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan
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Lerner SP, Skinner E, Skinner DG. RADICAL CYSTECTOMY IN REGIONALLY ADVANCED BLADDER CANCER. Urol Clin North Am 1992. [DOI: 10.1016/s0094-0143(21)00442-0] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Affiliation(s)
- H Matzkin
- Department of Urology, University of Tennessee, Memphis
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22
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Parkinson MC, Fisher C. ACP Broadsheet 130: November 1991. Gross examination of bladder specimens. J Clin Pathol 1991; 44:890-5. [PMID: 1752977 PMCID: PMC496624 DOI: 10.1136/jcp.44.11.890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- M C Parkinson
- Middlesex School of Medicine, Bland-Sutton Institute, Middlesex Hospital
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Siami P, Chinn S, Clayton M, Ray V, Rubenstein M, Guinan P. BCG in management of transitional cell carcinoma invasive to prostate. Urology 1989; 34:381-2. [PMID: 2595884 DOI: 10.1016/0090-4295(89)90447-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Transitional cell carcinoma invading the prostate is a difficult problem to manage. Transurethral resection of the bladder neck followed by intravesical bacillus Calmette-Guerin (BCG) is one suggested option.
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Affiliation(s)
- P Siami
- Division of Urology, Cook County Hospital, Illinois
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24
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Wood DP, Montie JE, Pontes JE, Levin HS. Identification of transitional cell carcinoma of the prostate in bladder cancer patients: a prospective study. J Urol 1989; 142:83-5. [PMID: 2733111 DOI: 10.1016/s0022-5347(17)38667-6] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Transitional cell carcinoma involving the prostate in patients with bladder carcinoma impacts on the judicious use of intravesical chemotherapy, partial cystectomy and internal urinary reservoirs anastomosed to the urethra. We compared the accuracy of prostate needle biopsy, fine needle prostatic aspiration and transurethral resection biopsies of the prostate to detect the presence or absence of transitional cell carcinoma involving the prostate in 25 men undergoing radical cystectomy, of whom 40 per cent had transitional cell carcinoma of the prostate. The accuracy of the 3 detection methods was 20, 40 and 90 per cent, respectively. If any 1 of the 3 tests was positive all patients with transitional cell prostatic cancer were correctly identified. These tests should be performed in high risk patients, including those with transitional cell carcinoma in situ of the bladder, or with a positive urine cytology study and a cystoscopically as well as biopsy proved normal bladder urothelium.
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Affiliation(s)
- D P Wood
- Department of Urology, Cleveland Clinic Foundation, Ohio
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Wood DP, Montie JE, Pontes JE, VanderBrug Medendorp S, Levin HS. Transitional cell carcinoma of the prostate in cystoprostatectomy specimens removed for bladder cancer. J Urol 1989; 141:346-9. [PMID: 2913357 DOI: 10.1016/s0022-5347(17)40762-2] [Citation(s) in RCA: 110] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Specimens from 84 radical cystectomies for bladder carcinoma performed between January 1984 and July 1986 were reviewed to characterize the involvement of the prostate with transitional cell carcinoma. Whole-mount sectioning of the prostate was performed at 4 mm. intervals and processed in the same manner as radical prostatectomy specimens. A total of 36 patients (43 per cent) had transitional cell carcinoma of the prostate: 94 per cent of these had prostatic urethra involvement and 6 per cent had a normal prostatic urethra but transitional cell carcinoma was present in the periurethral structures. In situ prostatic duct or acini, ejaculatory duct and seminal vesicle involvement occurred, respectively, in 67, 8 and 17 per cent of the patients with prostatic involvement. Of the patients with prostatic involvement 39 per cent had stromal invasion (22 per cent focal and 17 per cent diffuse invasion). The incidence of carcinoma in situ of the bladder neck or trigone (59 per cent), previous intravesical chemotherapy (59 per cent) and ureteral carcinoma (79 per cent) was significantly increased in patients with prostatic involvement. In patients with carcinoma in situ of the trigone or bladder neck, or in whom previous intravesical chemotherapy treatments have failed prostatic involvement should be suspected so that this disease can be detected before stromal invasion occurs.
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Affiliation(s)
- D P Wood
- Department of Urology, Cleveland Clinic Foundation, Ohio
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Soloway MS, Perry A. Bacillus Calmette-Guerin for treatment of superficial transitional cell carcinoma of the bladder in patients who have failed thiotepa and/or mitomycin C. J Urol 1987; 137:871-3. [PMID: 3106653 DOI: 10.1016/s0022-5347(17)44277-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Thirty patients with stage Ta carcinoma in situ or T1 superficial bladder cancer received 6 weeks of intravesical bacillus Calmette-Guerin. All patients had persistent or recurrent tumor despite thiotepa and/or mitomycin C. Response was determined by the results of endoscopy, bladder wash cytology and biopsy performed 4 weeks after the last dose of bacillus Calmette-Guerin. Of the 30 patients 15 (50 per cent) had a complete response. The likelihood of a complete response was better for those with initial Ta lesions (62 per cent) and carcinoma in situ (56 per cent) than for patients with an initial T1 lesion (25 per cent). Although the longest followup is only 36 months (mean 16 months) patients with a complete response have a much better prognosis in terms of subsequent tumor, need for cystectomy and death of bladder cancer.
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Matthews PN, Madden M, Bidgood KA, Fisher C. The clinicopathological features of metastatic superficial papillary bladder cancer. J Urol 1984; 132:904-6. [PMID: 6492279 DOI: 10.1016/s0022-5347(17)49939-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A review of the records of more than 1,000 patients with bladder cancer has led to the identification of 9 with superficial papillary tumors and no evidence of muscle invasion in whom distant metastases developed. The majority of these patients had multiple recurrent tumors that were difficult to control by endoscopic means and failed to respond to intravesical chemotherapy, Helmstein's therapy or radiotherapy. Of the patients 4 had superficial tumors in the prostatic ducts but no stromal invasion. In 7 patients with well or moderately differentiated tumors the histological grade was the same in the metastases. The sites of metastases were bone in 5 patients, lung in 3 and liver in 1, which suggested hematogenous spread of tumor. Histological evidence of microvascular invasion was seen in 2 of the resected bladder tumors. We conclude that failure to control bladder tumors by local means should be an indication for early cystectomy, even in patients with no evidence of muscle invasion.
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Kopelson G. Radiation therapy of prostatic carcinoma. Int J Radiat Oncol Biol Phys 1983; 9:599. [PMID: 6853262 DOI: 10.1016/0360-3016(83)90083-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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