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Purpose <p>Given that patients with muscle-invasive bladder cancer (MIBC) treated with radical cystoprostatectomy (RCP) have a high incidence of prostate cancer, and considering that incidental prostate cancer (iPCa) may be aggressive with potential negative impacts on overall survival (OS), this study aimed to investigate risk factors associated with OS in patients with MIBC accompanied by iPCa.</p> Methods <p>Bladder cancer patients who underwent RCP and had postoperative pathologically confirmed MIBC accompanied by iPCa were collected and regularly followed up. Basic information was recorded, as well as some clinical, laboratory, and immunohistochemistry indexes. Univariate and multivariate Cox regression analyses were used to identify the independent risk factors associated with overall survival (OS). OS was the endpoint, estimated by the Kaplan–Meier method.</p> Results <p>One hundred and eighty patients were included. The median follow-up time was 28&#xa0;months. Multivariate analysis showed that age, urinary frequency, albumin to globulin ratio (AGR), urinary urobilinogen, and cytokeratin 20 (CK20) were independent prognostic factors for OS. Compared with patients aged ≥ 78&#xa0;years, those aged &lt; 78&#xa0;years exhibited significantly longer median OS (<i>P</i> = 0.013). Patients with urinary frequency had a significantly shorter median OS than those without urinary frequency (<i>P</i> = 0.025). The median OS was longer in patients with an albumin to globulin ratio (AGR) &lt; 1.57 than in those with AGR ≥ 1.57 (<i>P</i> = 0.011). The median survival time was significantly shorter in patients with urinary urobilinogen than in those without urinary urobilinogen (<i>P</i> = 0.016). CK20-positive patients demonstrated significantly longer median OS than CK20-negative patients (<i>P</i> = 0.006).</p> Conclusion <p>Age, urinary frequency, AGR, urinary urobilinogen, and CK20 were strongly associated with OS. Consequently, we can conclude that these prognostic factors may serve as a valuable tool in guiding patients with MIBC accompanied by iPCa.</p>

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Prognostic prediction of incidental prostate cancer in radical cystoprostatectomy for muscle-invasive bladder cancer

  • 期刊论文

  • 发表日期：

    2025年10月23日

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  • Tao Zhang,
  • Jing Liu,
  • Lijuan Feng,
  • Changxing Ke

摘要

Purpose

Given that patients with muscle-invasive bladder cancer (MIBC) treated with radical cystoprostatectomy (RCP) have a high incidence of prostate cancer, and considering that incidental prostate cancer (iPCa) may be aggressive with potential negative impacts on overall survival (OS), this study aimed to investigate risk factors associated with OS in patients with MIBC accompanied by iPCa.

Methods

Bladder cancer patients who underwent RCP and had postoperative pathologically confirmed MIBC accompanied by iPCa were collected and regularly followed up. Basic information was recorded, as well as some clinical, laboratory, and immunohistochemistry indexes. Univariate and multivariate Cox regression analyses were used to identify the independent risk factors associated with overall survival (OS). OS was the endpoint, estimated by the Kaplan–Meier method.

Results

One hundred and eighty patients were included. The median follow-up time was 28 months. Multivariate analysis showed that age, urinary frequency, albumin to globulin ratio (AGR), urinary urobilinogen, and cytokeratin 20 (CK20) were independent prognostic factors for OS. Compared with patients aged ≥ 78 years, those aged < 78 years exhibited significantly longer median OS (P = 0.013). Patients with urinary frequency had a significantly shorter median OS than those without urinary frequency (P = 0.025). The median OS was longer in patients with an albumin to globulin ratio (AGR) < 1.57 than in those with AGR ≥ 1.57 (P = 0.011). The median survival time was significantly shorter in patients with urinary urobilinogen than in those without urinary urobilinogen (P = 0.016). CK20-positive patients demonstrated significantly longer median OS than CK20-negative patients (P = 0.006).

Conclusion

Age, urinary frequency, AGR, urinary urobilinogen, and CK20 were strongly associated with OS. Consequently, we can conclude that these prognostic factors may serve as a valuable tool in guiding patients with MIBC accompanied by iPCa.