Incidental prostate cancer detected by cystoprostatectomy in Korean men.

OBJECTIVES: To determine the incidence and characteristics of incidental prostate cancer diagnosed by cystoprostatectomy (CPT) in Korean men. METHODS: Thirty-six consecutive male patients scheduled to undergo CPT were prospectively enrolled. The CPT specimens were examined and the clinicopathologic characteristics of incidental cancers compared with those of T1c prostate cancers that had undergone radical prostatectomy. Complete transverse sections of the prostate were taken from the apex to the base at 4-mm intervals. RESULTS: Of the 36 CPT patients, 18 (50%) had incidental prostate cancer. Most of the incidental tumors were confined to the prostate gland, except in 1 patient. Tumor involvement at the prostate apex was found in 3 patients (16.7%), and Gleason scores in 3 cases were 7 to 10. Median tumor volume was 0.08 cm(3) (range, 0.01 to 20.51 cm(3)), and a tumor volume of more than 0.5 cm(3) was identified in 5 patients. Of these incidental prostate cancers, 38.9% (19.4% of all CPT patients) were clinically significant. As compared with the 38 T1c prostate cancer patients, incidental prostate cancer patients were older, had a lower prostate-specific antigen level, a lower grade, smaller tumor volume, and were less likely to have multiple tumors. However, no significant differences were observed between these two groups with respect to apical tumor involvement or tumor confinement to the prostate (P >0.05 for each). CONCLUSIONS: Incidental prostate cancers were diagnosed in 50% of CPT specimens, and 19.4% of these were clinically significant.