Introduction Prostate cancer (PCa) is the most common cancer in men

1. No. 077 Incidental Adenocarcinoma of Prostate in Radical Cystoprostatectomy Specimen, An Australian Study NarimanAhmadi, Warick J Delprado, Andrew J Brooks, Phillip C Brenner, Alexander Grant, Graham M Coombes, Manish I. Patel Urological Cancer Outcomes Centre, University of Sydney, Discipline of Surgery, NSW, Australia • Introduction • Prostate cancer (PCa) is the most common cancer in men • Higher rates of PCa has been noted in radical cystoprostatectomy (RCP) series • There is great variability in rates of incidental PCa in cystectomy series. 1,2 • Prostate sparing or apical sparing cystectomy is increasingly offered to achieve better potency and continence • Significance of the incidental prostate cancer remains undefined • There are limited Australian publication on this topic • Results • 129 patients underwent RCP for primary bladder cancer, mean age 70 years • Prostate adenocarcinoma present in 50 (39%), of which 35 (70%) were considered clinically significant • Apical cancer was present in 10 (8%) of which 8 (80%) were clinically significant • High Grade Prostate intraepithelial neoplasia (HGPIN) was present in 26 (20%) of specimen • Prostate cancer and HGPIN were more prevalent in older age group (Table 3) • Urothelial carcinoma was present in 15 (12%) • RCP performed for bladder CIS was strongly associated with urethral involvement (Pearson 2 test, P=0.008) Table 1: Histological distribution of adenocarcinoma of the prostate Aim To determine the incidence and tumour characteristics of incidental prostate cancer in Australian men undergoing radical cystoprostatectomy • Methods • Database of a major pathological centre (DHM) was reviewed for period of 10 years (1998-2008) • Ethics approval was obtained from NSW Ethics Committee • Specimen usually sampled 3-4 full faced slices. If cancer seen specimen recut at 4 mm interval slices • Significant PCa was defined using Stamey3 definition: • Gleason score of 7 or greater • Tumour volume of 0.5 cm3 or larger • Extra-prostatic extension or positive surgical margin • Staging was based on TNM 2009 classification and grading was based on ISUP/WHO 2004 classification • Data analysed by statistical software SPSS (SPSS Inc, IBM, version 19) Table 2: Age distribution and histopathology of the prostate Table 3: Histological and stage distribution of urothelial carcinoma in the prostate Captions to be set in Arial font italic and no smaller than 6 points, to the length of the column in case when a figure takes more than 2/3 of column width. • Conclusions • Higher rates of incidental PCa, HGPIN and urothelial malignancy were observed in patients undergoing radical cystoprostatectomy • Higher rates of clinically significant PCa was observed in the older subgroups • Bladder CIS was significantly associated with presence of urethral involvement • Clinical implication of this pathological finding remains controversial and requires further correlation clinically * Direct extension of primary bladder cancer to to prostate is not included • References • Revelo MP et al. Incidence and location of prostate and urothelial carcinoma in prostates from cystoprostatectomies: Implications for possible apical sparing surgery. J Urol, 2004, 171:646-651 • Kouriefs C et al. Incidentally detected prostate cancer in cystoprostatectomy specimens. Urol Int, 2005;75:213-216 • Stamey TA, et al. Localized prostate cancer. Relationship of tumor volume to clinical significance for treatment of prostate cancer. Cancer 1993; 71 (3 Suppl.): 933–8 Acknowledgements There are no conflict of interest Author would like to acknowledge the staff of Douglas Hanly Moir for their help in facilitating data collection Poster presentation sponsor