1
|
Ji J, Liu T, Yao Y, Liu W, Ning H, Wang T, Zhang G. Characteristics and survival of primary urothelial carcinoma of the prostate: A multi-center retrospective study of 18 cases. Neoplasia 2024; 47:100961. [PMID: 38142529 PMCID: PMC10788616 DOI: 10.1016/j.neo.2023.100961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/08/2023] [Accepted: 12/20/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVES To explore the features, treatment, and outcomes of primary urothelial carcinoma of the prostate (PUCP) in a multicenter study. METHODS The clinical and imaging features, pathological findings, treatment, and outcomes of patients diagnosed with PUCP from January 2011 to April 2022 at three institutions were collected and analyzed. The Kaplan-Meier method and log-rank test were used to assess survival rates of the overall group and survival differences between groups according to TNM stage. RESULTS The study cohort comprised 18 patients with PUCP of mean age 72.4±7.8 years. Dysuria and urinary frequency were the most common symptoms (77.8 %). Sixteen (88.9 %) patients had normal serum total PSA concentrations. Most patients showed abnormalities on urinalysis. MRI was the most accurate diagnostic imaging method (88.9 %). As to immunohistochemistry findings, GATA-3 (81.8 %) and P63 (84.6 %) were positive in most examined patients; however, no lesions were positive for PSA. Three (17.6 %) patients with T1N0M0 and T2N0M0 tumors underwent radical cystectomy. Eleven (64.7 %) patients which almost all had T4 tumors received systematic therapy, most of them receiving chemotherapy with gemcitabine and cisplatin, and radiotherapy. The median overall survival was 42 months, and the median progression-free survival 25 months, the latter being significantly longer in patients with T1-2 than in those with T3-4 disease (p=0.035). CONCLUSION PUCP, a rare but highly aggressive type of prostate cancer, should be considered in men with abnormalities on MRI and normal serum PSA concentrations. Positive GATA-3, P63, and negative PSA are typical immunohistochemistry features. Radical cystectomy and systematic therapies can be effective.
Collapse
Affiliation(s)
- Junjie Ji
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tian Liu
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yu Yao
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Wen Liu
- Department of Urology, Beijing Hospital, Beijing, China
| | - Hao Ning
- Department of Urology, Shandong Provincial Hospital, Jinan, China
| | - Tongyu Wang
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Guiming Zhang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China.
| |
Collapse
|
2
|
Wang A, Lam MK, Isharwal S. Urethral Mucinous Adenocarcinoma of the Prostate: An Uncommon and Diagnostically Complex Disease. Urology 2020; 146:e1-e2. [PMID: 33045285 DOI: 10.1016/j.urology.2020.09.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/14/2020] [Accepted: 09/28/2020] [Indexed: 11/26/2022]
Abstract
A 66-year-old male presented with hematuria and mucosuria. A transurethral resection of the prostate revealed adenocarcinoma in situ with mucinous features. He underwent a robotic-assisted radical prostatectomy with lymph node dissection. Pathology confirmed T2 primary mucin-producing urothelial type adenocarcinoma in the prostatic urethra. Urothelial adenocarcinoma arising in the prostatic urethra is an uncommon disease that warrants clear differentiation from other malignancies due to its aggressive nature. The differential includes urologic and gastrointestinal malignancies making diagnosis complex. Accurate diagnosis is critical to providing appropriate treatment as these patients are at high risk of developing recurrence and metastatic disease.
Collapse
Affiliation(s)
- Alexis Wang
- Department of Urology, Oregon Health & Science University, Portland, OR.
| | - Michael K Lam
- Department of Urology, Oregon Health & Science University, Portland, OR
| | - Sudhir Isharwal
- Department of Urology, Oregon Health & Science University, Portland, OR
| |
Collapse
|
3
|
Lee J, Yoo Y, Park S, Cho MS, Sung SH, Ro JY. Double cocktail immunostains with high molecular weight cytokeratin and GATA-3: useful stain to discriminate in situ involvement of prostatic ducts or acini from stromal invasion by urothelial carcinoma in the prostate. J Pathol Transl Med 2020; 54:146-153. [PMID: 32028755 PMCID: PMC7093285 DOI: 10.4132/jptm.2019.11.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/18/2019] [Accepted: 11/12/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Distinguishing prostatic stromal invasion (PSI) by urothelial carcinoma (UC) from in situ UC involving prostatic ducts or acini with no stromal invasion (in situ involvement) may be challenging on hematoxylin and eosin stained sections. However, the distinction between them is important because cases with PSI show worse prognosis. This study was performed to assess the utility of double cocktail immunostains with high molecular weight cytokeratin (HMWCK) and GATA-3 to discriminate PSI by UC from in situ UC involvement of prostatic ducts or acini in the prostate. METHODS Among 117 radical cystoprostatectomy specimens for bladder UCs, 25 cases showed secondary involvement of bladder UC in prostatic ducts/acini only or associated stromal invasion and of these 25 cases, seven cases revealed equivocal PSI. In these seven cases with equivocal PSI, HMWCK, and GATA-3 double immunohistochemical stains were performed to identify whether this cocktail stain is useful to identify the stromal invasion. RESULTS In all cases, basal cells of prostate glands showed strong cytoplasmic staining for HMWCK and UC cells showed strong nuclear staining for GATA-3. In cases with stromal invasion of UC, GATA-3-positive tumor cells in the prostatic stroma without surrounding HMWCK-positive basal cells were highlighted and easily recognized. Among seven equivocal cases, two cases showed PSI and five in situ UC in the prostate. In two cases, the original diagnoses were revised. CONCLUSIONS Our study suggested that HMWCK and GATA-3 double stains could be utilized as an adjunct method in the distinction between PSI by UC from in situ UC involving prostatic ducts or acini.
Collapse
Affiliation(s)
- Junghye Lee
- Department of Pathology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Youngeun Yoo
- Department of Pathology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Sanghui Park
- Department of Pathology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Min-Sun Cho
- Department of Pathology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Sun Hee Sung
- Department of Pathology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Jae Y. Ro
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital and Weill Medical College of Cornell University, Houston, TX, USA
| |
Collapse
|
4
|
Abstract
RATIONALE Prostatic urothelial carcinoma is a rare disease. Medical misdiagnosis rates remain high because there are no specific clinical symptoms or imaging features, which decreases patient survival. We report a case of prostatic urethral cancer confirmed by transrectal ultrasound-guided prostate biopsy because of an abnormal digital rectal exam. PATIENT CONCERNS A 55-year-old man was referred to our hospital due to lower urinary tract symptoms that lasted for 5 years. DIAGNOSES AND INTERVENTIONS On digital rectal examination, a hard and enlarged prostate was detected. Computed tomography, bone scintigraphy, and magnetic resonance imaging indicated benign prostatic hyperplasia. The patient underwent transrectal ultrasound-guided prostate biopsy. From the histopathological examination and immunohistochemical markers, a diagnosis of high-grade prostatic urothelial carcinoma was made. We excluded the possibility of urothelial cancer originating in the bladder lining after transurethral resection of the bladder. Radical cystoprostatectomy was performed, followed by 6 cycles of cisplatin and gemcitabine chemotherapy. Postoperative pathology showed primary urothelial carcinoma of the prostate. OUTCOMES The patient recovered smoothly after surgery. After a 6-month follow-up, no evidence of local recurrence or metastatic disease was found. LESSONS This case reminds clinicians that, for middle-aged men with suspicious digital rectal examinations, a diagnosis of prostatic urothelial carcinoma should be considered. Initial radical surgery followed by combination chemotherapy is suggested for therapeutic management.
Collapse
Affiliation(s)
- Jun Zhou
- Department of Urology, The First Affiliated Hospital of Anhui Medical University
- Institute of Urology and Anhui Province Key Laboratory of Genitourinary Diseases
| | - Cheng Yang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University
- Institute of Urology and Anhui Province Key Laboratory of Genitourinary Diseases
| | - Zhaoxiang Lu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University
- Institute of Urology and Anhui Province Key Laboratory of Genitourinary Diseases
| | - Li Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University
- Institute of Urology and Anhui Province Key Laboratory of Genitourinary Diseases
| | - Yu Yin
- Department of Urology, The First Affiliated Hospital of Anhui Medical University
- Department of Pathology, Anhui Medical University, Hefei, China
| | - Sheng Tai
- Department of Urology, The First Affiliated Hospital of Anhui Medical University
- Institute of Urology and Anhui Province Key Laboratory of Genitourinary Diseases
| | - Chaozhao Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University
- Institute of Urology and Anhui Province Key Laboratory of Genitourinary Diseases
| |
Collapse
|
5
|
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]
|
6
|
Primary transitional cell carcinoma of the prostate: a male disease with dismal prognosis despite cisplatin-based systemic chemotherapy. JOURNAL OF MEN'S HEALTH 2010. [DOI: 10.1016/j.jomh.2009.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
7
|
Barbisan F, Mazzucchelli R, Scarpelli M, Lopez-Beltran A, Cheng L, Kirkali Z, Montironi R. Urothelial and incidental prostate carcinoma in prostates from cystoprostatectomies for bladder cancer: is there a relationship between urothelial and prostate cancer? BJU Int 2009; 103:1058-63. [DOI: 10.1111/j.1464-410x.2008.08207.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
8
|
Walsh DL, Chang SS. Dilemmas in the treatment of urothelial cancers of the prostate. Urol Oncol 2008; 27:352-7. [PMID: 18439852 DOI: 10.1016/j.urolonc.2007.12.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2007] [Revised: 12/13/2007] [Accepted: 12/13/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The objective of this paper is to examine the contemporary incidence, diagnosis, and treatment of prostatic urothelial carcinoma and make recommendations on the current dilemmas of treating urothelial cancer of the prostate. METHODS A review of English-language literature from 1990 to the present was performed utilizing the U.S. National Library of Medicine's Pub Med database. Keywords used were urothelial cell carcinoma, prostatic urethral involvement, prostatic duct/acini involvement, carcinoma in situ. Bibliographies of reviewed articles were also searched. RESULTS Transitional cell carcinoma of the bladder with involvement of the prostate has been reported in multiple studies with an incidence between 12% and 48%. Stromal invasion of the prostate has a reported incidence between 7% and 17%. The incidence of primary transitional cell carcinoma of the prostate has been estimated at 1% to 4% of prostatic malignancies. Degree and depth of prostatic invasion has prognostic significance with 5-year survival rates being 100% for those with urethral mucosal involvement, 50% with ductal/acinar involvement, and 40% with prostatic stromal invasion. The actual anatomic path that urothelial carcinoma invasion occurs also has prognostic significance. Those with contiguous malignant involvement had a 7% 5-year survival rate compared with those with noncontiguous involvement and a 46% 5-year survival rate. CONCLUSIONS Prostatic urothelial carcinoma is often under appreciated and not well understood. Malignant involvement of different anatomic locations of the prostate (i.e., mucosa, ducts, acini, and stroma) influence not only diagnosis but treatment of disease. Although debate exists regarding optimal therapy for mucosal involvement, if the prostatic stroma is involved, radical cystoprostatectomy is the treatment of choice.
Collapse
Affiliation(s)
- Dena L Walsh
- Department of Urology, Vanderbilt University, Nashville, TN 37232, USA.
| | | |
Collapse
|
9
|
Abstract
Transitional cell carcinoma of the prostate (TCCP) has become a well recognized entity, showing an increasing incidence due to the growing research awareness. TCCP is part of the well known pan-urothelial disease: the urologist, therefore, is strongly recommended to consider the prostate at any time in the management of superficial and invasive bladder cancer. Several cases are diagnosed in association with bladder cancer (secondary TCCP): primary prostatic transitional cell carcinoma arises ‘de novo’ as first tumour of the prostate urothelium and is rare. Prognosis depends on the prostate invasion degree. No reliable staging systems are presently available. Non-invasive TCCP can be successfully treated with conservative means (TUR +/- BCG), whereas stromal invasive TCCP must be aggressively treated with radical cystectomy. TCCP can interphere with surgeon's decisions about urinary diversion in patients undergoing radical cystectomy for urothelial cancer. (Urologia 2007; 74: 15–21)
Collapse
Affiliation(s)
- PF Bassi
- Clinica Urologica, Università Cattolica del Sacro Cuore, Roma
| | - R. Falabella
- Clinica Urologica, Università Cattolica del Sacro Cuore, Roma
| | - F. Pinto
- Clinica Urologica, Università Cattolica del Sacro Cuore, Roma
| | - E. Sacco
- Clinica Urologica, Università Cattolica del Sacro Cuore, Roma
| | - M. Racioppi
- Clinica Urologica, Università Cattolica del Sacro Cuore, Roma
| |
Collapse
|
10
|
Shen SS, Lerner SP, Muezzinoglu B, Truong LD, Amiel G, Wheeler TM. Prostatic involvement by transitional cell carcinoma in patients with bladder cancer and its prognostic significance. Hum Pathol 2006; 37:726-34. [PMID: 16733214 DOI: 10.1016/j.humpath.2006.01.027] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2005] [Revised: 01/23/2006] [Accepted: 01/25/2006] [Indexed: 10/24/2022]
Abstract
To study the importance of prostatic involvement by transitional cell carcinoma (TCC) in patients with bladder cancer, we examined the entire prostates by whole-mount sections from 214 radical cystoprostatectomy specimens for detailed patterns of involvement by TCC and correlated the results with lymph node metastasis and patients' survival. Prostatic involvement by TCC was detected in 69 (32%) of 214 cases. Among them, 30 (43%) patients had carcinoma in situ (CIS) and the other 39 (57%) were invasive TCC. Carcinoma in situ occurred in either prostatic urethra (n = 6, 20%) or, more commonly, in prostatic ducts/acini (n = 14, 47%), and in a combination of prostatic urethra and ducts (n = 10, 33%). Ten (26%) of the invasive TCC resulted from direct penetration from the primary tumor in the bladder, and the remaining 29 (72%) cases arose from prostatic urethra/ducts, of which 11, 13, and 5 invaded the lamina propria, prostatic stroma, and periprostatic or seminal vesical tissue, respectively. Both prostatic TCC involvement and nodal metastasis were highly significant prognostic factors for patients' survival and the survival significance of prostatic TCC involvement still existed regardless of lymph node status. Furthermore, the presence of prostatic CIS and degrees of prostatic invasion are associated with nodal metastasis and survival. Patients with prostatic CIS or urethral lamina propria invasion had a similar, but higher incidence of lymph node metastasis and lower long-term and 5-year survival than those patients without prostatic involvement. Similarly, prostatic stromal invasion and periprostatic/seminal vesical invasion had a similar, but much higher nodal metastasis and worse survival than patients with only prostatic CIS or urethral lamina propria invasion. In summary, presence of prostatic TCC involvement and levels of involvement are significant prognostic factors in patients with bladder cancer.
Collapse
Affiliation(s)
- Steven S Shen
- Department of Pathology, The Methodist Hospital, Houston, TX 77030, USA.
| | | | | | | | | | | |
Collapse
|
11
|
Mallén Mateo E, Gil Martínez P, Sancho Serrano C, García de Jalón Martínez A, Pascual Regueiro D, Gil Sanz MJ, Rioja Sanz LA. Carcinoma transicional primario puro de próstata. revisión de nuestra serie. Actas Urol Esp 2004; 28:377-80. [PMID: 15264680 DOI: 10.1016/s0210-4806(04)73092-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Primary prostate transitional cell carcinoma is a very uncommon tumor, that represents about 1% of all prostate tumours. In our institution, only six patients have been diagnosed with pure transitional cell prostate carcinoma until 2002. Bladder origin of the neplasic was ruled out in all cases. We report a study about the progression and survival of prostate transitional cell carcinoma. These prostatic tumours carry a poor prognostic (median survival is 4.6 months) with a strong tendency to metastatic spread. Therefore, we suggest a radical prostatectomy (without cystectomy) when it rules out bladder origin tumour.
Collapse
Affiliation(s)
- E Mallén Mateo
- Servicio de Urología, Hospital Universitario Miguel Servet, Zaragoza
| | | | | | | | | | | | | |
Collapse
|
12
|
Transitional Cell Carcinoma Involving The Prostate: A Clinicopathological Retrospective Study Of 76 Cases. J Urol 2003. [DOI: 10.1097/00005392-200301000-00036] [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]
|
13
|
Njinou Ngninkeu B, Lorge F, Moulin P, Jamart J, Van Cangh PJ. Transitional cell carcinoma involving the prostate: a clinicopathological retrospective study of 76 cases. J Urol 2003; 169:149-52. [PMID: 12478124 DOI: 10.1016/s0022-5347(05)64056-6] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE We reviewed the degree to which extension from transitional cell carcinoma into the prostate affects survival. We also compared whether prostatic stromal invasion occurring via direct extension through the bladder wall differs from stromal invasion arising intraurethrally. MATERIALS AND METHODS A total of 76 men who underwent radical cystectomy for transitional cell carcinoma also had prostate involvement. Patients were separated into group 1-18 with primary bladder tumor extending transmurally through the bladder wall to invade the prostate and group 2-58 with prostate involvement arising from within the prostatic urethra. In the latter group the degree of prostate invasion was classified as urethral mucosal involvement, ductal/acinar involvement and stromal invasion. RESULTS The 5-year overall survival and recurrence-free rate were 22% and 28% in group 1 versus 43% and 45% in group 2, respectively. In group 2 survival rates were similar in those with prostatic urethral and ductal tumors (without stromal invasion). Five-year overall survival rates without and with stromal invasion were 49% and 25%, respectively (p = 0.024). Prostate involvement decreased survival, which varied according to primary bladder stages (Pis, P1, P2a/b and P3a/b, p = 0.004) or superficial (Pis, Pa and P1) and muscle invasive (P2a/b and P3/b, p = 0.045), disease in 2 groups. Those with positive lymph nodes experienced poorer outcomes in each group. The 5-year overall survival rate in the 19 men with positive lymph nodes was 13% and it was 44% with negative lymph nodes (p = 0.034). The major prognostic factors were age, degree of prostate invasion and lymph node involvement. CONCLUSIONS The invasion pathways of prostate invasion in patients with transitional cell bladder carcinoma have a statistically significant prognostic role in survival. Transitional cell carcinoma of the bladder extending into the prostate through the bladder wall and bladder carcinoma that did not directly infiltrate the prostate through the bladder wall are 2 distinct clinicopathological entities that should not be included in the same staging grade.
Collapse
Affiliation(s)
- B Njinou Ngninkeu
- Division of Urology, Department of Pathology, Cliniques Universitaires Mont-Godinne and Saint-Luc, Université Catholique de Louvain, Yvoir, Belgium
| | | | | | | | | |
Collapse
|
14
|
Nixon RG, Chang SS, Lafleur BJ, Smith JA JA, Cookson MS. Carcinoma in situ and tumor multifocality predict the risk of prostatic urethral involvement at radical cystectomy in men with transitional cell carcinoma of the bladder. J Urol 2002; 167:502-5. [PMID: 11792906 DOI: 10.1097/00005392-200202000-00012] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Determining which patients are at risk for prostatic urethral involvement of urothelial carcinoma may alter assessment of the prostatic urethra before radical cystectomy and ultimately influence the choice of urinary diversion. We determined risk factors predictive of prostatic urethral involvement using preoperative bladder tumor characteristics in male patients who underwent radical cystoprostatectomy due to urothelial carcinoma of the bladder. MATERIALS AND METHODS We reviewed 192 consecutive radical cystectomy specimens from men with transitional cell carcinoma from June 1995 to June 2000. The prostatic urethra in each specimen was analyzed and urethral involvement was characterized as carcinoma in situ, intraductal invasion or prostatic stromal invasion. We then examined which clinical bladder tumor characteristics correlated with the incidence and extent of prostatic urethral involvement by performing multiple variable analysis. RESULTS Prostatic urethral involvement was evident in 30 of the 192 patients (15.6%). Of the 80 patients with carcinoma in situ in the bladder 25 (31.3%) had concomitant prostatic urethral involvement with carcinoma, whereas only 5 (4.5%) of the 112 with no evidence of carcinoma in situ had prostatic urethral involvement. Likewise 25 of the 72 patients (34.7%) with multifocal tumors had concomitant prostatic urethral involvement with carcinoma, whereas only 5 (4.2%) of the 120 with no evidence of multifocality had prostatic urethral involvement. In the multiple variable logistic regression model the odds of prostatic urethral involvement were 12 and 15-fold greater when carcinoma in situ and tumor multifocality were present, respectively. CONCLUSIONS Carcinoma in situ and/or tumor multifocality are valuable prognostic indicators of prostatic urethral involvement. However, in their absence prostatic urethral involvement was rare. Ultimately the extent of prostatic urethral involvement may influence decisions, such as the choice of urinary diversion and need for urethrectomy, in men undergoing radical cystectomy.
Collapse
Affiliation(s)
- Randy G Nixon
- Department of Urologic Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-2765, USA
| | | | | | | | | |
Collapse
|
15
|
Queipo Zaragozá JA, Budía Alba A, Pérez Ebrí M, Vera Donoso CD, Vera Sempere F, Jiménez Cruz JF. [Primary transitional carcinoma of the prostatic ductus]. Actas Urol Esp 2000; 24:406-12. [PMID: 10965577 DOI: 10.1016/s0210-4806(00)72471-5] [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: 10/27/2022]
Abstract
Primary prostate transitional cell carcinoma is a very rare tumour originating in the transitional epithelial cells of the intraprostate periurethral ductus. Only 17 of 829 patients diagnosed with prostate carcinoma were found to have the transitional cell variety. Eight (8) of those had pure transitional cell carcinoma and 9 a mixed presentation of acinar adenocarcinoma and transitional cell ductal carcinoma. Bladder origin of the tumour was ruled out in all cases. We report a retrospective study on the clinical behaviour of prostate transitional cell carcinoma. Compared to acinar carcinomas, few differences were found when age, symptoms, physical findings and imaging diagnosis were evaluated. Clinical presentation, DRE, PSA, metastatic spread and presence of supravesical obstructive uropathy where also studied to establish a diagnosis. Radiotherapy was the most frequently used therapeutical approach. Mean survival is 26.6 months (4-60 months) and there has been 11 death up to now. Compared to acinar forms, this tumour shows a hormone-resistant, aggressive biological behaviour with poor prognosis. Early diagnosis and radical surgery are the only options available to increase life expectancy for these patients.
Collapse
|
16
|
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.
Collapse
Affiliation(s)
- C Varo Solís
- Servicio de Urología, Hospital Universitario de Puerto Real, Cádiz
| | | | | | | | | | | | | |
Collapse
|
17
|
Pagano F, Bassi P, Drago Ferrante GL, Piazza N, Abatangelo G, Pappagallo GL, Garbeglio A. Is Stage pT4a (D1) Reliable in Assessing Transitional Cell Carcinoma Involvement of the Prostate in Patients with a Concurrent Bladder Cancer? A Necessary Distinction for Contiguous or Noncontiguous Involvement. J Urol 1996. [DOI: 10.1016/s0022-5347(01)66605-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Francesco Pagano
- Department of Urology, University of Padova, Padova, and Epidemiology-Clinical Trials Office, Department of Medical Oncology, Noale, Italy
| | - Pierfrancesco Bassi
- Department of Urology, University of Padova, Padova, and Epidemiology-Clinical Trials Office, Department of Medical Oncology, Noale, Italy
| | - Giovanni L. Drago Ferrante
- Department of Urology, University of Padova, Padova, and Epidemiology-Clinical Trials Office, Department of Medical Oncology, Noale, Italy
| | - Nicola Piazza
- Department of Urology, University of Padova, Padova, and Epidemiology-Clinical Trials Office, Department of Medical Oncology, Noale, Italy
| | - Giuseppe Abatangelo
- Department of Urology, University of Padova, Padova, and Epidemiology-Clinical Trials Office, Department of Medical Oncology, Noale, Italy
| | - Giovanni L. Pappagallo
- Department of Urology, University of Padova, Padova, and Epidemiology-Clinical Trials Office, Department of Medical Oncology, Noale, Italy
| | - Antonio Garbeglio
- Department of Urology, University of Padova, Padova, and Epidemiology-Clinical Trials Office, Department of Medical Oncology, Noale, Italy
| |
Collapse
|
18
|
Is Stage pT4a (D1) Reliable in Assessing Transitional Cell Carcinoma Involvement of the Prostate in Patients with a Concurrent Bladder Cancer? A Necessary Distinction for Contiguous or Noncontiguous Involvement. J Urol 1996. [DOI: 10.1097/00005392-199601000-00084] [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]
|
19
|
Ishigooka M, Yaguchi H, Tomaru M, Sasagawa I, Nakada T, Mitobe K. Mixed prostatic carcinoma containing malignant squamous element. Reports of two cases. SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY 1994; 28:425-7. [PMID: 7886421 DOI: 10.3109/00365599409180526] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Two cases of mixed prostatic carcinoma are reported. A 67-year-old man with mixed urothelial and squamous cell carcinoma died 10 months after diagnosis despite hormonal therapy and pelvic irradiation. A 70-year-old man with adenosquamous carcinoma responded well to such treatment.
Collapse
Affiliation(s)
- M Ishigooka
- Department of Urology, Yamagata University, School of Medicine, Japan
| | | | | | | | | | | |
Collapse
|
20
|
Reese JH, Freiha FS, Gelb AB, Lum BL, Torti FM. Transitional cell carcinoma of the prostate in patients undergoing radical cystoprostatectomy. J Urol 1992; 147:92-5. [PMID: 1729557 DOI: 10.1016/s0022-5347(17)37142-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
To assess the impact of prostatic involvement with transitional cell carcinoma we reviewed the clinical outcome of 49 patients with transitional cell carcinoma of the prostate. In addition, 115 step-sectioned cystoprostatectomy specimens removed for bladder transitional cell carcinoma were studied to determine the true incidence of secondary prostatic involvement by transitional cell carcinoma. Specimens from 300 prostates removed for prostatic adenocarcinoma also were reviewed to investigate the presence of incidental transitional cell carcinoma arising within the prostate. Transitional cell carcinoma was found in 29% of the step-sectioned specimens and in none of the radical prostatectomy specimens. The presence of prostatic invasion either into the stroma or involving prostatic ducts and acini only had no adverse effect on outcome. Lymph node status and bladder stage, and not prostatic invasion were the determining factors of survival. The presence of seminal vesicle involvement or prostatic stromal invasion appeared to predict for lymph node involvement. With a mean followup of more than 3 years 75% of our patients who had negative lymph nodes and low stage bladder lesions are alive without evidence of disease. In our series prostatic involvement by transitional cell carcinoma did not impact on survival when patients were treated aggressively with radical cystoprostatectomy.
Collapse
Affiliation(s)
- J H Reese
- Department of Pathology and Medicine, Stanford University School of Medicine, San Jose, California 95128
| | | | | | | | | |
Collapse
|
21
|
Affiliation(s)
- H Matzkin
- Department of Urology, University of Tennessee, Memphis
| | | | | |
Collapse
|
22
|
Takashi M, Sakata T, Nagai T, Kato T, Sahashi M, Koshikawa T, Miyake K. Primary transitional cell carcinoma of prostate: case with lymph node metastasis eradicated by neoadjuvant methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) therapy. Urology 1990; 36:96-8. [PMID: 2368239 DOI: 10.1016/0090-4295(90)80324-g] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A case of transitional cell carcinoma of the periurethral prostatic ducts received neoadjuvant chemotherapy consisting of methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC), which eradicated pelvic lymph node metastasis, followed by cystoprostatectomy. M-VAC therapy may be indicated for metastatic transitional cell carcinoma of the periurethral prostatic ducts.
Collapse
Affiliation(s)
- M Takashi
- Department of Urology, Nagoya University, School of Medicine, Japan
| | | | | | | | | | | | | |
Collapse
|
23
|
|
24
|
Hardeman SW, Perry A, Soloway MS. Transitional cell carcinoma of the prostate following intravesical therapy for transitional cell carcinoma of the bladder. J Urol 1988; 140:289-92. [PMID: 3135420 DOI: 10.1016/s0022-5347(17)41585-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
From 1983 to 1986, 63 male patients received various regimens of intravesical therapy for superficial transitional cell carcinoma of the bladder. Of these 63 patients 10 were subsequently diagnosed as having transitional cell carcinoma of the prostate. Five of the 10 patients had no tumor remaining in the bladder at diagnosis of transitional cell carcinoma of the prostate. In 3 patients tumor in the prostate was more invasive than tumor in the bladder. In 2 patients tumor involvement was greater in the bladder than in the prostate. Patients undergoing treatment with intravesical therapy for transitional cell carcinoma of the bladder, especially those receiving multiple courses for prolonged periods, should be monitored closely for the development of transitional cell carcinoma of the prostate.
Collapse
Affiliation(s)
- S W Hardeman
- Department of Urology, University of Tennessee-Memphis, Baptist Memorial Hospital
| | | | | |
Collapse
|
25
|
Androulakakis PA, Schneider HM, Jacobi GH, Hohenfellner R. Coincident vesical transitional cell carcinoma and prostatic carcinoma. Clinical features and treatment. BRITISH JOURNAL OF UROLOGY 1986; 58:153-6. [PMID: 3697629 DOI: 10.1111/j.1464-410x.1986.tb09016.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Twenty-two patients with vesical urothelial carcinoma associated with prostatic carcinoma were reviewed. They represented 1.5% of the bladder and prostatic tumours treated in our department within a 12-year period from 1968 to 1979. Their management included several treatment policies, based on the separate assessment of each tumour variant. For non-infiltrating bladder tumours, transurethral tumour resection was combined with hormonal treatment, external radiotherapy or resection of the prostate depending on the stage of the prostatic tumour. Radical cystoprostatectomy was performed for two cases of infiltrating bladder tumour with well localised prostatic tumours. A conservative primary approach seems justifiable in the management of double carcinoma of the bladder and prostate. The coincidence of bladder urothelial carcinoma and prostatic carcinoma per se is not an adverse prognostic factor; prognosis is more closely related to the pathological stage and grade of the bladder tumour. Cystoprostatectomy for patients with infiltrating bladder tumours could be curative, in selected cases, for the prostatic cancer as well.
Collapse
|
26
|
Sawczuk I, Tannenbaum M, Olsson CA, deVere White R. Primary transitional cell carcinoma of prostatic periurethral ducts. Urology 1985; 25:339-43. [PMID: 3885546 DOI: 10.1016/0090-4295(85)90481-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
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.
Collapse
|
27
|
|
28
|
Abstract
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.
Collapse
|
29
|
Alexander SJ, Lee SS, Bekhrad A. Transitional cell carcinoma of the prostate: response to treatment with cisplatinum and cyclophosphamide. J Urol 1984; 131:975-7. [PMID: 6538603 DOI: 10.1016/s0022-5347(17)50736-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
We observed a remarkable clinical response to cisplatinum and cyclophosphamide in a patient with widespread metastatic transitional cell cancer of the prostate after hormonal therapy proved ineffective. Combination chemotherapy has the potential for an impressive response in these patients.
Collapse
|
30
|
Selman SH, Goldblatt PJ, Christoforidis AJ, Klaunig JE, Collard RK, Jhunjhunwala JS, Kropp KA. Osteoblastic lesions in a patient with a bladder filling defect. J Urol 1983; 130:522-5. [PMID: 6887367 DOI: 10.1016/s0022-5347(17)51286-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
31
|
Vacirca F, Bartolotta G, Amico F. Il Tumore a Cellule Tradizionali Della Prostata: Contributo Casistico. Urologia 1983. [DOI: 10.1177/039156038305000340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
32
|
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]
|
33
|
Chibber PJ, McIntyre MA, Hindmarsh JR, Hargreave TB, Newsam JE, Chisholm GD. Transitional cell carcinoma involving the prostate. BRITISH JOURNAL OF UROLOGY 1981; 53:605-9. [PMID: 7317750 DOI: 10.1111/j.1464-410x.1981.tb03271.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Transitional cell carcinoma involving the prostate gland was studied in 27 patients. Three different groups were recognised on the basis of the clinical pattern and histological findings. Each group has a different prognosis and merits a different approach to treatment. Thus, stromal involvement of the prostate by transitional cell carcinoma is a sinister finding that requires radical treatment, whereas ductal involvement by either carcinoma in situ or non-invasive papillary tumours can be managed less aggressively. This study emphasises that the present classification for these tumours is unsatisfactory and that adequate histopathological information is essential for their management.
Collapse
|