Practice patterns and recurrence after partial cystectomy for bladder cancer.
Nader Fahmy1, Armen Aprikian, Simon Tanguay
1Department of Surgery (Urology), McGill University, Montreal, QC, Canada.
World Journal of Urology
|October 15, 2009
Summary
Partial cystectomy (PC) is used more often than expected for invasive bladder cancer. Patients undergoing PC had similar survival to radical cystectomy (RC), but require lifelong follow-up due to recurrence risk.
Area of Science:
- Urology
- Oncology
- Surgical Oncology
Background:
- Partial cystectomy (PC) is an alternative to radical cystectomy (RC) for select invasive bladder cancer cases.
- Understanding practice patterns and outcomes for PC is crucial for optimizing bladder cancer management.
Purpose of the Study:
- To analyze practice patterns and recurrence rates following partial cystectomy (PC) for invasive bladder cancer.
- To compare outcomes of PC with upfront radical cystectomy (RC) using population-based data.
Main Methods:
- Retrospective analysis of billing records for PC and RC for bladder cancer in Quebec (1983-2005).
- Data included patient demographics, surgical details, recurrence dates, salvage RC, and survival.
- Statistical comparison of 5-year overall survival between PC and upfront RC groups.
Main Results:
- 714 patients (30.4%) with invasive bladder cancer underwent PC, often at non-academic centers (65%).
- Pelvic lymphadenectomy was underutilized (23%), as was ureteral reimplantation (13%).
- 23.7% of PC patients required salvage RC; 5-year overall survival was similar to upfront RC (49.8% vs. 51%).
Conclusions:
- The rate of PC for invasive bladder cancer is higher than anticipated.
- Underutilization of pelvic lymphadenectomy in PC cases is noted.
- Lifelong follow-up is recommended due to the potential for late recurrence after PC.
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