Urologic oncology · 2026
Incidental bladder cancer detected by routine cystoscopy before robot-assisted radical prostatectomy: A multicenter retrospective study.
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Nozaki Masakazu, Nakagawa Ryunosuke, Kadono Yoshifumi, Koketsu Yoshiki, Kamijima Taiki, Kano Hiroshi, Makino Tomoyuki, Naito Renato, Iwamoto Hiroaki, Yaegashi Hiroshi, Shigehara Kazuyoshi, Nohara Takahiro, Izumi Kouji, Nishikawa Takao, Shinagawa Tomochika, Yamauchi Hiroki, Takata Masayuki, Kono Masanori, Komatsu Kazuto, Mizokami Atsushi
Аннотация
INTRODUCTION: To evaluate the role of routine cystoscopy before robot-assisted radical prostatectomy (RARP) in detecting incidental bladder cancer (BC) and to identify clinical factors associated with BC detection.
METHODS: In this retrospective study conducted at 2 institutions, we included 918 patients who underwent routine cystoscopy before RARP between August 2014 and March 2025. We assessed incidental BC detection, detection of intermediate- or high-risk nonmuscle-invasive BC (NMIBC), and cystoscopy-related events, including urinary tract infection (UTI) and changes in planned prostate cancer (CaP) treatment.
RESULTS: Incidental BC was detected in 18 of 918 patients (1.96%), including 8 cases of intermediate- or high-risk NMIBC. Increasing age was significantly associated with BC detection (odds ratio [OR] per 1-year increase, 1.13; 95% confidence interval [CI], 1.02-1.25). Patients aged ≥70 years had a higher BC detection rate (3.2%; OR, 3.96; 95% CI, 1.29-12.1). Nine patients switched to alternative CaP treatments, including radiotherapy and/or androgen deprivation therapy. Among the 9 patients who underwent RARP after bladder tumor resection, the median interval from cystoscopy to RARP was 10.8 months, with no clinically evident CaP progression before RARP. During a median follow-up of 34.6 months, no BC recurrence or dissemination-suggestive recurrence was identified. UTI occurred in 6 patients (0.7%).
CONCLUSION: Routine cystoscopy before RARP identified previously unrecognized BC, including clinically significant lesions. Older age was associated with BC detection; however, this finding should be regarded as hypothesis-generating. Further prospective studies are needed to determine whether age-based or risk-adapted cystoscopy strategies are appropriate before RARP.
METHODS: In this retrospective study conducted at 2 institutions, we included 918 patients who underwent routine cystoscopy before RARP between August 2014 and March 2025. We assessed incidental BC detection, detection of intermediate- or high-risk nonmuscle-invasive BC (NMIBC), and cystoscopy-related events, including urinary tract infection (UTI) and changes in planned prostate cancer (CaP) treatment.
RESULTS: Incidental BC was detected in 18 of 918 patients (1.96%), including 8 cases of intermediate- or high-risk NMIBC. Increasing age was significantly associated with BC detection (odds ratio [OR] per 1-year increase, 1.13; 95% confidence interval [CI], 1.02-1.25). Patients aged ≥70 years had a higher BC detection rate (3.2%; OR, 3.96; 95% CI, 1.29-12.1). Nine patients switched to alternative CaP treatments, including radiotherapy and/or androgen deprivation therapy. Among the 9 patients who underwent RARP after bladder tumor resection, the median interval from cystoscopy to RARP was 10.8 months, with no clinically evident CaP progression before RARP. During a median follow-up of 34.6 months, no BC recurrence or dissemination-suggestive recurrence was identified. UTI occurred in 6 patients (0.7%).
CONCLUSION: Routine cystoscopy before RARP identified previously unrecognized BC, including clinically significant lesions. Older age was associated with BC detection; however, this finding should be regarded as hypothesis-generating. Further prospective studies are needed to determine whether age-based or risk-adapted cystoscopy strategies are appropriate before RARP.