Urethral recurrence in women with orthotopic bladder substitutes: A multi-institutional study
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články, multicentrická studie
PubMed
25744654
DOI
10.1016/j.urolonc.2015.01.020
PII: S1078-1439(15)00054-X
Knihovny.cz E-zdroje
- Klíčová slova
- Female, Neobladder, Radical cystectomy, Recurrence, Urethral,
- MeSH
- cystektomie metody MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru MeSH
- míra přežití MeSH
- mladý dospělý MeSH
- močový měchýř patologie MeSH
- nádory močového měchýře mortalita patologie chirurgie MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
OBJECTIVES: To evaluate risk factors for urethral recurrence (UR) in women with neobladder. MATERIAL AND METHODS: From 1994 to 2011, 297 women (median age = 54 y; 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.
1st Faculty of Medicine Charles University Prague Czech Republic
2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Urology University Hospital Tübingen Tübingen Germany
Department of Urology University of Bern Bern Switzerland
Urology and Nephrology Center Mansoura University Mansoura Egypt
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