PD67-02 CRITICAL EVALUATION OF THE SELECTION CRITERIA FOR PROSTATE SPARING CYSTECTOMY: DO WE NEED TO TIGHTEN THEM?

You have accessJournal of UrologyBladder Cancer: Invasive VII1 Apr 2017PD67-02 CRITICAL EVALUATION OF THE SELECTION CRITERIA FOR PROSTATE SPARING CYSTECTOMY: DO WE NEED TO TIGHTEN THEM? Mohamed Saad M., Rafael Sanchez-Salas, Eric Barret, Marc Galiano, François Rozet, Nathalie Cathala, Annick Mombet, Dominique Prapotnich, and Xavier Cathelineau Mohamed Saad M.Mohamed Saad M. More articles by this author , Rafael Sanchez-SalasRafael Sanchez-Salas More articles by this author , Eric BarretEric Barret More articles by this author , Marc GalianoMarc Galiano More articles by this author , François RozetFrançois Rozet More articles by this author , Nathalie CathalaNathalie Cathala More articles by this author , Annick MombetAnnick Mombet More articles by this author , Dominique PrapotnichDominique Prapotnich More articles by this author , and Xavier CathelineauXavier Cathelineau More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2978AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate Sparing cystectomy is a valid option for the treatment of patient with bladder cancer provided that strict selection criteria are used. Although that there is a uniform agreement on excluding patients with bladder neck tumors as well as patients with suspicious prostate that may harbor prostatic carcinoma, there has not been a standardized consensus on how to safely exclude them. Furthermore, the exclusion of other criteria such as carcinoma in situ, tumor characteristics and presence of preoperative hydronephrosis have not been clearly elucidated. METHODS We retrospectively reviewed our laparoscopic/robotic assisted laparoscopic prostate sparing cystectomy series to evaluate our method of selecting patients. RESULTS Between 2001 and 2011, 60 patients were treated with laparoscopic or robotic PSC for muscle invasive or recurrent non muscle invasive bladder cancer. Mean follow up time was 76.9 months ±33.3SD. When the preoperative PSA cut off value for biopsy was = 4ng/dl; prostatic adenocarcinoma was detected on final pathology in 2 patients and arised de novo in 1 patient. When the value was lowered to 2.5ng/dl, no patient had incidental prostatic carcinoma and none developed de novo carcinoma. Distant/solitary carcinoma in situ was associated with more recurrences and so did preoperative hydronephrosis. Tumor grade, size and number were not associated with more recurrences. CONCLUSIONS The presence of any carcinoma in situ should be a contraindication to prostate sparing cystectomy. In addition to standard prostatic evaluation, a cut off PSA value of = 2.5ng/dl for biopsy can eliminate any chance of harboring or developing a prostatic cancer. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1277 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Mohamed Saad M. More articles by this author Rafael Sanchez-Salas More articles by this author Eric Barret More articles by this author Marc Galiano More articles by this author François Rozet More articles by this author Nathalie Cathala More articles by this author Annick Mombet More articles by this author Dominique Prapotnich More articles by this author Xavier Cathelineau More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...