Urethral recurrence in women with orthotopic bladder substitutes: A multi-institutional study.

Gakis, Georgios; Ali-El-Dein, Bedeir; Babjuk, Marko; Hrbacek, Jan; Macek, Petr; Burkhard, Fiona C.; Thalmann, George; Shaaban, Atallah-Abdel; Stenzl, Arnulf (2015). Urethral recurrence in women with orthotopic bladder substitutes: A multi-institutional study. Urologic oncology - seminars and original investigations, 33(5), 204.e17-204.e23. Elsevier 10.1016/j.urolonc.2015.01.020

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OBJECTIVES To evaluate risk factors for urethral recurrence (UR) in women with neobladder. MATERIAL AND METHODS From 1994 to 2011, 297 women (median age = 54y; interquartile range: 47-57) underwent radical cystectomy with ileal neobladder for bladder cancer in 4 centers. None of the patients had bladder neck involvement at preoperative assessment. Univariable and multivariable analyses were used to estimate recurrence-free survival and overall survival. The median follow-up was 64 months (interquartile range: 25-116). RESULTS Of the 297 patients, 81 developed recurrence (27%). The 10- and 15-year recurrence-free survival rates were 66% and 66%, respectively. The 10- and 15-year overall survival rates were 57% and 55%, respectively. UR occurred in 2 patients (0.6%) with solitary urethral, 4 (1.2%) with concomitant urethral and distant recurrence, and 1 with concomitant urethral and local recurrence (0.3%). Bladder tumors were located at the trigone in 27 patients (9.1%). None of these patients developed UR. Lymph node tumor involvement was present in 60 patients (20.2%). On univariable and multivariable analyses, pathologic tumor and nodal stage were independent predictors for the overall risk of recurrence. UR was associated with a positive final urethral margin status (P<0.001) whereas no significant associations were found for carcinoma in situ, pathologic tumor and nodal stage, and bladder trigone involvement. CONCLUSIONS In this series, only 0.6% of women developed solitary UR. A positive final urethral margin was associated with an increased risk of UR. Women with involvement of the bladder trigone were not at higher risk of UR.

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:

Burkhard, Fiona C. and Thalmann, George

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1078-1439

Publisher:

Elsevier

Language:

English

Submitter:

Katharina Morgenegg

Date Deposited:

24 Jun 2015 07:29

Last Modified:

05 Nov 2015 10:32

Publisher DOI:

10.1016/j.urolonc.2015.01.020

PubMed ID:

25744654

Uncontrolled Keywords:

Female; Neobladder; Radical cystectomy; Recurrence; Urethral

BORIS DOI:

10.7892/boris.69758

URI:

https://boris.unibe.ch/id/eprint/69758

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