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The effect of prior prostate cancer treatment on perioperative and pathological outcomes after cystectomy
Kassem S Faraj1, Weslyn D Bunn2, Victoria S Edmonds2
1Department of Urology, Mayo Clinic Hospital, Phoenix, Arizona, USA.
Introduction:
A comprehensive analysis on outcomes in the perioperative and pathological setting in patients with a prior diagnosis of prostate cancer has not been performed. The objective of this study is to describe the effect of prior prostate cancer treatment on perioperative and pathological outcomes after cystectomy.
Materials And Methods:
This was a retrospective review of all male patients who underwent cystectomy at our institution from 01/01/2007-01/01/2020. Patients who were previously diagnosed and treated for prostate cancer were identified and outcomes were assessed.
Results:
In 525 male patients, 132 (25.1%) had a diagnosis of prostate cancer prior to cystectomy. In the patients with a history of prostate cancer, 59 (46.2%) patients underwent prior radical prostatectomy (RP), 52 (39.4%) underwent some form of radiation therapy and the remaining 21 were managed with other modalities, including 11.4% who were on active surveillance. When comparing perioperative outcomes, there were no significant differences in outcomes. Pathological outcomes revealed that pT4 disease was more common in the RT cohort (19.2%, p = 0.05). In patients with no history of prostate cancer, 151 (40.2%) were found to have incidental prostate cancer at the time of cystectomy. Most (67.5%) patients with incidental prostate cancer had Gleason < 7 disease and only 1.3% developed metastatic prostate cancer on follow up, compared to over 10% of the patients previously treated for prostate cancer (p < 0.05).
Conclusions:
Patients who underwent prostate cancer treatment prior to cystectomy may be at increased risk for worse perioperative and pathologic outcomes after cystectomy.
