Clinical Edge

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Preoperative Prostatectomy Screening Identifies Bladder Cancer

Key clinical point: Preoperative screening identified bladder cancer that could be managed prior to prostatectomy in the majority of patients. “This information should be useful for designing a strategy for candidates for prostatectomy,” noted the investigators.

Major finding: Incidental urothelial cancer was found in 9 of 430 (2.1%) of patients scheduled for prostatectomy; 7 underwent prostatectomy after tumor resection.

Study details: The data come from a prospective cohort study of 430 prostatectomy patients.

Disclosures: The researchers had no financial conflicts to disclose.

COMMENTARY

Second primary malignancies are well recognized, but data and guidelines on how to manage multiple primary malignancies are sparse. Concurrent bladder cancer identified at the time of prostate cancer diagnosis is well recognized. Soga et. al describe the experience at one center where surveillance for bladder cancer is conducted via cystoscopy and urine testing at the time of prostate cancer diagnosis when prostatectomy is under consideration. The authors identified that the incidence of bladder cancer concurrent with new prostate cancer was 2.1%, which is in the middle of the range of incidence reported in other studies. This center takes a conservative approach to prostate cancer treatment, starting androgen deprivation therapy while waiting on average one year after bladder cancer treatment before commencing with local prostate cancer treatment. In this small sample, no prostate or bladder cancer recurrences were identified, suggesting such an approach has merit.—Mark A. Klein, MD

Citation:

Soga N et al. Curr Urol. 2019;13:145-9 doi.org/10.1159/000499278.