Clinicopathological characteristics and assessment of risk factors for incidentally discovered prostatic cancer in patients undergoing radical cystectomy with urothelial carcinoma of the bladder

Background: This retrospective study analyzed data from patients undergoing radical cystoprostatectomy (RCP) for bladder urothelial carcinoma. We analyzed their features with regard to prevalence, clinicopathological characteristics and evaluated the risk of incidental prostatic adenocarcinoma (IPCa). Methods: Clinical data and pathological features of 237 patients who underwent standard RCP for bladder urothelial carcinoma were included in this study. Correlations between bladder tumor size, number of tumors, histological grade, pathological stage, patient age, and incidental prostate cancer were examined. Human epidermal growth factor receptor 2 (HER2) expression was evaluated using immunohistochemistry (IHC), and its association with clinicopathological features was analyzed. Results: = 0.024), with the proportion of conventional urothelial carcinoma being the highest in the HER2 0/1+ group (86.6%). Conclusions: IPCa is not uncommon in patients undergoing radical cystectomy. It is of great significance to evaluate the risk factors for informing surgical strategy and postoperative management. Our analysis further demonstrates that HER2 expression status correlates significantly with tumor size and histology in urothelial carcinoma. Specifically, tumors with HER2 2+ expression exhibited a smaller median diameter, while the classic histological subtype was predominantly observed in HER2 0/1+ tumors. These associations indicate that differential HER2 expression may delineate distinct pathological phenotypes of bladder urothelial carcinoma.