Prostate Involvement in Bladder Cancer: Prevalence and Associated Risk Factors in Patients Undergoing Radical Cystoprostatectomy

Introduction: Bladder cancer (BC) is a major malignancy, and prostate involvement is a critical clinical concern influencing prognosis and treatment. Current BC management includes neoadjuvant chemotherapy followed by radical cystectomy, with emerging immunotherapies offering promising new avenues. Prostate involvement, reported in ۱۵–۴۸% of radical cystectomy cases, may occur via direct invasion or urethral spread, with stromal invasion indicating a worse prognosis. Risk factors include bladder carcinoma in situ (CIS), multifocal tumors, bladder neck involvement in prostate involvement, higher tumor grade/stage, and prior pelvic radiotherapy.Methods: This retrospective study investigated the prevalence and risk factors for prostate involvement in ۲۸۱ patients with BC who underwent radical cystoprostatectomy at Alzahra and Khorshid Hospitals, Isfahan, Iran, between ۲۰۱۷ and ۲۰۲۲. Data were collected from medical records on demographics, pathological findings (tumor stage, lymph node involvement, prostate involvement, tumor size, and distance from the bladder neck), and PSA levels. Statistical analysis was performed using SPSS v۲۶, employing the Chi-square test, independent t-test, and Mann–Whitney U test.Results: Prostate involvement was observed in ۱۳.۹% (۳۹/۲۸۱) of patients. Significant correlations were found between prostate involvement and higher tumor stage (P-value<۰.۰۰۱), lymph node involvement (P-value<۰.۰۰۱), larger tumor size (P-value=۰.۰۰۹), shorter distance to the bladder neck (P-value<۰.۰۰۱), and higher PSA levels (P-value<۰.۰۰۱). No significant relationship was found with age, smoking, or hospital type.Conclusion: Prostate involvement in BC is relatively common. Higher tumor stage, lymph node involvement, larger tumor size, and proximity to the bladder neck are key predictors. These findings highlight the need for a comprehensive evaluation of high-risk BC patients to improve treatment planning and oncological outcomes.

کلیدواژه ها:

Bladder Cancer ، Prostate involvement ، Radical Cystoprostatectomy ، risk factors