Treatment and outcomes of urethral recurrence of urinary bladder cancer in women after radical cystectomy and orthotopic neobladder: a series of 12 cases

Hrbáček, Jan; Macek, Petr; Ali-El-Dein, Bedeir; Thalmann, George; Stenzl, Arnulf; Babjuk, Marek; Shaaban, Atallah A; Gakis, Georgios (2015). Treatment and outcomes of urethral recurrence of urinary bladder cancer in women after radical cystectomy and orthotopic neobladder: a series of 12 cases. Urologia internationalis, 94(1), pp. 45-49. Karger 10.1159/000363112

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INTRODUCTION

The incidence, treatment, and outcome of urethral recurrence (UR) after radical cystectomy (RC) for muscle-invasive bladder cancer with orthotopic neobladder in women have rarely been addressed in the literature.

PATIENTS AND METHODS

A total of 12 patients (median age at recurrence: 60 years) who experienced UR after RC with an orthotopic neobladder were selected for this study from a cohort of 456 women from participating institutions. The primary clinical and pathological characteristics at RC, including the manifestation of the UR and its treatment and outcome, were reviewed.

RESULTS

The primary bladder tumors in the 12 patients were urothelial carcinoma in 8 patients, squamous cell carcinoma and adenocarcinoma in 1 patient each, and mixed histology in 2 patients. Three patients (25%) had lymph node-positive disease at RC. The median time from RC to the detection of UR was 8 months (range 4-55). Eight recurrences manifested with clinical symptoms and 4 were detected during follow-up or during a diagnostic work-up for clinical symptoms caused by distant metastases. Treatment modalities were surgery, chemotherapy, radiotherapy, and bacillus Calmette-Guérin urethral instillations. Nine patients died of cancer. The median survival after the diagnosis of UR was 6 months.

CONCLUSIONS

UR after RC with an orthotopic neobladder in females is rare. Solitary, noninvasive recurrences have a favorable prognosis when detected early. Invasive recurrences are often associated with local and distant metastases and have a poor prognosis. © 2014 S. Karger AG, Basel.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology

UniBE Contributor:

Thalmann, George

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0042-1138

Publisher:

Karger

Language:

English

Submitter:

Katharina Morgenegg

Date Deposited:

26 Feb 2015 14:38

Last Modified:

05 Dec 2022 14:40

Publisher DOI:

10.1159/000363112

PubMed ID:

25171129

BORIS DOI:

10.7892/boris.63418

URI:

https://boris.unibe.ch/id/eprint/63418

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