Management of transitional cell carcinoma of the prostate

Prostatic occurrence of transitional cell carcinoma after intravesical chemotherapy

Thirteen patients with Stage Tis, Ta, or T1 transitional cell carcinoma (TCC) of the bladder treated by transurethral resections and intravesical chemotherapy developed TCC of the prostate. Among the 13 cases, cytology specimens were obtained from 10 at the time prostatic disease was diagnosed; 9 demonstrated TCC. One was treated successfully by transurethral resection of a Ta lesion involving the prostatic urethra only. One of 2 patients declining radical surgery is alive with residual disease at twenty-four months, and the other died of progressive disease at nineteen months. Of the 10 patients who underwent radical cystoprostatectomy, 7 are alive with no evidence of disease eight to forty-two months postoperatively, with 2 of these 7 having received 4 courses of systemic methotrexate, vincristine, Adriamycin, and cisplatinum (MVAC) for metastatic disease. Two of the 10 died of metastatic disease six and thirteen months postoperatively, and one frail patient died of surgical complications. When treating patients with intravesical chemotherapy for superficial TCC, biopsy of the prostate should be done during follow-up examinations, especially in the presence of cytologic or palpable prostatic abnormalities.

Primary transitional cell carcinoma of prostatic periurethral ducts

Primary transitional cell carcinoma of the prostatic periurethral ducts is a distinct histologic variety of prostate carcinoma. Traditional methods of therapy for adenocarcinoma of the prostate are ineffective. A review of the literature suggests that appropriate radical surgical therapy should be considered for early control of this disease.

Primary transitional cell carcinoma of prostate

Primary transitional cell carcinoma of the prostate (TCC-P) is a rare tumor for which definitive therapy remains undefined. To establish a basis for therapy, we analyzed 3 new cases and reviewed the literature. The following points were observed: (1) the true diagnosis is often missed at initial pathologic examination; (2) the tumor has a propensity for extensive local invasion; and (3) it commonly presents with obstructive symptoms in relatively young patients. Treatment recommendations based on our review include: maintenance of a high index of suspicion, especially for fifty to sixty-year-old men with prostate tumors or for suspected prostatic adenocarcinoma that is rapidly progressive and/or unresponsive to hormonal therapy; preoperative pelvic irradiation followed by radical cystoprostatourethrectomy is the treatment of choice in low-stage disease, and combined radiation therapy and chemotherapy should be used for disease beyond the prostate.

The management of transitional cell carcinoma in the prostate

Transitional cell carcinoma of the prostate is a rare tumour. A review of 318 patients with carcinoma of the prostate presenting to this hospital in the 5 years between April 1974 and April 1979 revealed 7 patients with transitional cell carcinoma arising within the prostate. Two of these had previously been treated for a transitional cell carcinoma of the bladder. These prostatic tumours are usually poorly differentiated and carry a poor prognosis. Early radical surgery, however, achieved a good result in one of our patients. Other forms of treatment were ineffective and a review of the literature revealed that this was also the experience of others. We suggest that cystoprostatectomy should be considered as an early form of treatment.

Conservative management of low grade neoplasms of the male urethra: a preliminary report

Between 1965 and 1977, 8 men with low grade urethral neoplasms were treated with local excision or a combination of local excision and local chemotherapeutic agents. The tumors were in the anterior urethra in 5 cases and the posterior urethra in 3. Histology included 2 transitional cell papillomas, 3 squamous cell carcinomas, 1 transitional cell carcinoma, 1 mesonephric carcinoma and 1 intraductal transitional cell carcinoma in situ. All neoplasms were controlled by local measures for 1 to 13 years. This experience suggests that local treatment may be an acceptable alternative to a radical operation in certain well localized low grade urethral neoplasms in men.

Transitional cell carcinoma: cause of refractory cancer of prostate

Four cases with a diagnosis of adenocarcinoma of the prostate are presented in which a histologic pattern of adenocarcinoma mixed with transitional cell carcinoma developed subsequently. Suggestions are made regarding the pathogenesis and diagnosis.

Prostatic involvement by transitional cell carcinoma: pathogenesis, patterns and prognosis

Prostatic involvement by transitional cell carcinoma of the bladder includes a spectrum of histologic patterns. Ductal only or ductal and acinar involvement occurs with or without stromal invasion. Stromal invasion may exist without glandular involvement. Invasive prostatic patterns are most frequent in the setting of high stage invasive bladder tumors and 5-year survival rates for these patients are low. Non-invasive in situ prostatic patterns are usually associated with low stage bladder tumors and 5-year survival approaches that predicted from radical cystectomy for low stage bladder tumor alone. When an invasive pattern is associated with a low stage bladder tumor the 5-year survival rate is determined by the prostatic lesion and is low. Although the survival rate is severely jeopardized by stromal prostatic invasion the prognosis is not hopeless. Preoperative radiotherapy followed by cystoprostatourethrectomy can be expected to produce a 20 per cent 5-year survival rate.