Is prostate-specific antigen surveillance necessary in men with benign prostate pathology following radical cystoprostatectomy for bladder cancer?

Trinity J. Bivalacqua, Stacy Loeb, Phillip M. Pierorazio, Mark P. Schoenberg, Alan W. Partin, Thomas J. Guzzo

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Radical cystoprostatectomy (RCP) remains the gold standard for the treatment of muscle-invasive bladder cancer. There are limited data regarding the clinical impact and detection of PSA following complete prostatectomy or the need to monitor serum PSA in patients with benign prostate pathology at time of RCP. The purpose of our study was to analyze the postoperative PSA characteristics of men without prostate cancer who underwent a RCP for bladder cancer. Methods: The demographic, clinical and pathologic data were reviewed on 138 men who underwent RCP for bladder cancer from 1994 to 2008. Patients with known or incidentally discovered prostate cancer on final pathology were excluded from this study, and postoperative serum PSA values were reviewed in the remaining men. Results: The median age of the study population was 64 years (range 40-84). At a mean follow-up of 40.7 months, 137 (99.3%) of patients had an undetectable serum PSA. The one (0.7%) case in which serum PSA was not undetectable underwent an apex-sparing prostatectomy at the time of cystectomy. Conclusions: Serum PSA should remain undetectable for men with benign prostate pathology undergoing complete prostatectomy at the time of RCP. Elevated serum PSA following complete RCP in men with bladder cancer and pathologically confirmed benign prostate findings is rare. If the serum PSA is undetectable 3 months after RCP with benign prostate pathology, there is no need for continued PSA monitoring. These data support the notion that potential nonprostatic sources of PSA are clinically insignificant following complete removal of the prostate.

Original languageEnglish (US)
Pages (from-to)466-469
Number of pages4
JournalUrologia Internationalis
Volume85
Issue number4
DOIs
StatePublished - Dec 2010
Externally publishedYes

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Prostate-Specific Antigen
Urinary Bladder Neoplasms
Prostate
Pathology
Serum
Prostatectomy
Prostatic Neoplasms
Cystectomy
Demography
Muscles
Population

Keywords

  • Prostate-specific antigen
  • Radical cystoprostatectomy

ASJC Scopus subject areas

  • Urology

Cite this

Is prostate-specific antigen surveillance necessary in men with benign prostate pathology following radical cystoprostatectomy for bladder cancer? / Bivalacqua, Trinity J.; Loeb, Stacy; Pierorazio, Phillip M.; Schoenberg, Mark P.; Partin, Alan W.; Guzzo, Thomas J.

In: Urologia Internationalis, Vol. 85, No. 4, 12.2010, p. 466-469.

Research output: Contribution to journalArticle

Bivalacqua, Trinity J. ; Loeb, Stacy ; Pierorazio, Phillip M. ; Schoenberg, Mark P. ; Partin, Alan W. ; Guzzo, Thomas J. / Is prostate-specific antigen surveillance necessary in men with benign prostate pathology following radical cystoprostatectomy for bladder cancer?. In: Urologia Internationalis. 2010 ; Vol. 85, No. 4. pp. 466-469.
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abstract = "Background: Radical cystoprostatectomy (RCP) remains the gold standard for the treatment of muscle-invasive bladder cancer. There are limited data regarding the clinical impact and detection of PSA following complete prostatectomy or the need to monitor serum PSA in patients with benign prostate pathology at time of RCP. The purpose of our study was to analyze the postoperative PSA characteristics of men without prostate cancer who underwent a RCP for bladder cancer. Methods: The demographic, clinical and pathologic data were reviewed on 138 men who underwent RCP for bladder cancer from 1994 to 2008. Patients with known or incidentally discovered prostate cancer on final pathology were excluded from this study, and postoperative serum PSA values were reviewed in the remaining men. Results: The median age of the study population was 64 years (range 40-84). At a mean follow-up of 40.7 months, 137 (99.3{\%}) of patients had an undetectable serum PSA. The one (0.7{\%}) case in which serum PSA was not undetectable underwent an apex-sparing prostatectomy at the time of cystectomy. Conclusions: Serum PSA should remain undetectable for men with benign prostate pathology undergoing complete prostatectomy at the time of RCP. Elevated serum PSA following complete RCP in men with bladder cancer and pathologically confirmed benign prostate findings is rare. If the serum PSA is undetectable 3 months after RCP with benign prostate pathology, there is no need for continued PSA monitoring. These data support the notion that potential nonprostatic sources of PSA are clinically insignificant following complete removal of the prostate.",
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N2 - Background: Radical cystoprostatectomy (RCP) remains the gold standard for the treatment of muscle-invasive bladder cancer. There are limited data regarding the clinical impact and detection of PSA following complete prostatectomy or the need to monitor serum PSA in patients with benign prostate pathology at time of RCP. The purpose of our study was to analyze the postoperative PSA characteristics of men without prostate cancer who underwent a RCP for bladder cancer. Methods: The demographic, clinical and pathologic data were reviewed on 138 men who underwent RCP for bladder cancer from 1994 to 2008. Patients with known or incidentally discovered prostate cancer on final pathology were excluded from this study, and postoperative serum PSA values were reviewed in the remaining men. Results: The median age of the study population was 64 years (range 40-84). At a mean follow-up of 40.7 months, 137 (99.3%) of patients had an undetectable serum PSA. The one (0.7%) case in which serum PSA was not undetectable underwent an apex-sparing prostatectomy at the time of cystectomy. Conclusions: Serum PSA should remain undetectable for men with benign prostate pathology undergoing complete prostatectomy at the time of RCP. Elevated serum PSA following complete RCP in men with bladder cancer and pathologically confirmed benign prostate findings is rare. If the serum PSA is undetectable 3 months after RCP with benign prostate pathology, there is no need for continued PSA monitoring. These data support the notion that potential nonprostatic sources of PSA are clinically insignificant following complete removal of the prostate.

AB - Background: Radical cystoprostatectomy (RCP) remains the gold standard for the treatment of muscle-invasive bladder cancer. There are limited data regarding the clinical impact and detection of PSA following complete prostatectomy or the need to monitor serum PSA in patients with benign prostate pathology at time of RCP. The purpose of our study was to analyze the postoperative PSA characteristics of men without prostate cancer who underwent a RCP for bladder cancer. Methods: The demographic, clinical and pathologic data were reviewed on 138 men who underwent RCP for bladder cancer from 1994 to 2008. Patients with known or incidentally discovered prostate cancer on final pathology were excluded from this study, and postoperative serum PSA values were reviewed in the remaining men. Results: The median age of the study population was 64 years (range 40-84). At a mean follow-up of 40.7 months, 137 (99.3%) of patients had an undetectable serum PSA. The one (0.7%) case in which serum PSA was not undetectable underwent an apex-sparing prostatectomy at the time of cystectomy. Conclusions: Serum PSA should remain undetectable for men with benign prostate pathology undergoing complete prostatectomy at the time of RCP. Elevated serum PSA following complete RCP in men with bladder cancer and pathologically confirmed benign prostate findings is rare. If the serum PSA is undetectable 3 months after RCP with benign prostate pathology, there is no need for continued PSA monitoring. These data support the notion that potential nonprostatic sources of PSA are clinically insignificant following complete removal of the prostate.

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