NDP01: Oncologic outcomes of partial cystectomy compared to radical cystectomy for muscle invasive bladder cancer
  • 196 views,
  • 2019-01-04,
  • 上傳者: TUA秘書處,
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部分膀胱切除手術相較於膀胱全切除手術於肌肉侵犯膀胱癌之腫瘤相關預後
沈志宇、蔡育賢、歐建慧、楊文宏
國立成功大學醫學院附設醫院 泌尿部
Oncologic Outcomes of Partial Cystectomy Compared to Radical Cystectomy for Muscle Invasive Bladder Cancer
Chih-Yu Shen, Yuh-Shyan Tsai, Chien Hui Ou, Wen Horng Yang
Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan
 
 
Purpose: To our knowledge partial cystectomy is a bladder sparing procedure that has been performed in highly selected patients with muscle invasive bladder cancer. We evaluated patterns of recurrence and survival in a contemporary cohort of patients treated with partial vs radical cystectomy for bladder cancer.
Materials and Methods: From 2008 to 2017, we identified 27 patients who underwent partial cystectomy (PC) for pT2-4 N0-1 Mx urothelial carcinoma at our institution. During the same period, 49 patients with muscle invasive bladder cancer underwent radical cystectomy (RC). Overall survival (OS), disease specific survival (DSS), progression free survival (PFS) and advanced recurrence free survival was estimated using Kaplan-Meier analysis and compared with the log rank test.
Results: Median postoperative followup was 44.4 months in PC group and 46.7months in RC group . No significant difference was noted for 5-year progression free survival (56.1 % vs 61.5%, p = 0.950), advance recurrence free survival (76.9% vs. 61.5%,p=0.078), overall survival (56.9% vs 76.7%, p = 0.326), and disease specific survival (84.8 % vs 80.7%, p=0.687) between patients treated with partial and radical cystectomy, respectively. On univariate analysis gender, pathology stage and adjuvant chemotherapy was related to progression free rate and the status of residual tumor was related to advance recurrence and overall survival. On multivariate analysis, adjuvant chemotherapy was predictor of advance recurrence. P=0.038(OR:3.63,95% CI:1.074-12.269)
4 of 27 patients (14.8%) who underwent partial cystectomy developed extravesical tumor recurrence postoperatively versus 18 of 49 (36.7%) who underwent radical cystectomy. In addition, 8 patients (29.6%) were diagnosed with intravesical recurrence of tumor after partial cystectomy and 18 of 27 (66.6%) are currently disease-free with an intact bladder.
Conclusions: Our analysis demonstrated no difference in recurrence-free, disease specific or overall survival between selected patients receiving partial cystectomy and those receiving radical cystectomy. However, late extravesical tumor recurrence is not uncommon and they remain at risk for intravesical recurrence. Thus, they should be counseled and surveilled accordingly.
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    發表時間 :
    2019-01-04 16:31:40
    觀看數 :
    196
    發表人 :
    TUA秘書處
    部門 :
    台灣泌尿科醫學會
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