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PATHOLOGICAL CHANGES IN THE PROSTATE OF THE PATIENTS TREATED FOR BLADDER CANCER
Article published in Urologia Polska 1999/52/1.

authors

Tomasz Demkow 1, Anna Nasierowska-Guttmejer 2, Paweł Wiechno 1, Grzegorz Madej 1
1 Klinika Nowotworów Układu Moczowego Instytutu Onkologii w Warszawie
Kierownik Kiliniki: prof. dr hab. G. Madej
2 Zakład Patomorfologii Instytutu Onkologii w Warszawie
Dyrektor Instytutu: prof. dr hab. n. med. A. Kułakowski

keywords

prostate transitional cell carcinoma adenocarcinoma granuloma

summary

Objective. The aim of the study is to assess pathological changes in the
prostate of patients treated for bladder cancer.
Material and methods. 62 patients underwent radical cystoprostatecto-
my for advanced bladder cancer. Before surgery 11 patients received neo-
adjuvant systemic chemotherapy, 3 patients had radiotherapy (patients re-
fused cystectomy), 3 patients had neoadjuvant systemic chemotherapy and
radiotherapy, 6 patients underwent BCG bladder instillations for superfi-
cial bladder cancer, 2 patients had BCG bladder instillations and systemic
chemotherapy. The specimens has been fixed in the paraffin and stained
with hematoxilin eosin. The pathological changes has been assessed accor-
ding to TNM classification.
Results. In 23 specimens no pathological changes were found in prostate
gland. In this group clinical stages has been assessed as following: 7 pa-
tients - T3G2N()M()/ 4 patients - T2G2N0M0, 8 patients - T3G3N()M0, 4 pa-
tients T2G3N()M0. In 7 specimens transitional cell carcinoma of the bladder
invaded the prostate through the bladder wall (clinical stages ? 1 patient
T2G3N0M() , 2 patients T3G2N()MU , 4 patients T3G3N0M()). In 11 specimens
clinical stages ? 1 patient T2G2N0M(), 3 patients T2G3N(
T3G2N0M0), 3 patients T3G3NQM0) separate foci of cancer in the bladder and
prostate has been found. In situ component has been found in: prostatic
urethra in 2 patients, periurethral glands in 3 patients, prostatic ducts and
acini in 3 patients, stroma in 3 patients. Adenoca of the prostate was iden-
tified in 9 specimens (5 patients pTH, 3 patients pT]b, 1 patient pT2). Multi-
focal intraepithełial neoplasia ? PIN was present in 3 specimens. In this
group clinical stages of bladder carcinoma has been assessed: 4 patients
- T2G3N0M0, 5 patients - T3G2N()M{), 3 patients T3G3N()M()). In 9 prostate
glands (clinical stages of the bladder cancer: 1 patient T3G3N()M0, 4 patients
T3G2, 4 patients T2G2N0M0) granulomas were present: 4 patients after intra-
vesical BCG instillations, 3 patients after neoadjuvant systemic chemothe-
rapy, and 2 patients after intravesical BCG instillations and neoadjuvant
chemotherapy. Before treatment serum PSA level has been estimated in 22
patients.
Conclusions. 1. Adenocarcinoma and transitionall cell carcinoma of the
prostate fre±uently coexists with transitional cell carcinoma of the bladder.
2. TCC of the prostate gland derives from urethra, periurethral glands, acini
and stroma. 3. Following BCG intravesical instillations granulomas were very
often identified in the prostate gland.

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