2018年至2021年膀胱部分切除術單中心經驗回顧

李定廉¹、黃志平¹、張兆祥¹、葉進仲¹、楊啟瑞¹、張議徽¹

中國醫藥大學附設醫院 泌尿部¹

A single center experience review of partial cystectomy from 2018 to 2021

Ting-Lien Li¹, Chi-Ping Huang¹, Chao-Shiang Chang¹, Ching-Chung Yeh¹, Chi-Ray Yang¹, Yi-Hui Chang¹

Department of Urology China Medical University Hospital, Taichung, Taiwan¹

Purpose: Partial cystectomy (PC) is a bladder-sparing treatment option for bladder cancer, intended for a carefully selected group of patients. This study aimed to evaluate the outcomes of PC in a recent cohort of patients treated at a single institution.

Material and methods: Medical records were reviewed for 40 patients diagnosed with primary urothelial carcinoma (UC) who underwent partial cystectomy with curative intent at China Medical University Hospital between 2018 and 2021. The primary endpoints included noninvasive recurrence (defined as any recurrence of non-muscle invasive disease), advanced recurrence (defined as muscle-invasive recurrence or metastasis), and mortality. Unadjusted Cox proportional hazards regression and log-rank tests were employed to assess associations between clinical characteristics and these endpoints.

Results: In a cohort of 40 patients with bladder cancer treated by partial cystectomy, the median age was 71 years (interquartile range 45-81), with 70% male patients. Preoperative neoadjuvant chemotherapy (NAC) was administered to 42% of patients, while 85% received perioperative intravesical chemotherapy at the time of surgery. Pathologic staging revealed that 30% had tumors classified as <T2, and 70% had tumors classified as ≥T2. Lymph node involvement was observed in 25% of cases, and 12% had positive surgical margins. The mean follow-up period was 37 months (range 1-100 months), with a five-year overall survival rate of 65%. Out of 40 patients, 22 (55%) experienced no recurrence, 10 (25%) had noninvasive intravesical recurrence, and 8 (20%) had advanced recurrences. Four patients (10%) died due to bladder cancer.

Conclusions: In well-selected patients, partial cystectomy offers adequate local control of bladder cancer. The risk of systemic progression is similar to reported case series of RC.