Investigating the Potential to Offer Reproductive Organ Preserving Radical Cystectomy to More Female Bladder Cancer...

Area of Science:

• Urology
• Gynecologic Oncology
• Surgical Oncology

Background:

• Traditional radical cystectomy (tRC) involves extensive organ removal in female bladder cancer (BC) patients.
• Reproductive organ preserving radical cystectomy (ROPRC) offers a less invasive alternative with comparable survival and improved functional outcomes.
• The study evaluates the current use and potential for increased adoption of ROPRC.

Purpose of the Study:

• To determine the number of ROPRC performed at a single institution.
• To assess the potential for increased ROPRC adoption based on preoperative criteria.
• To analyze the accuracy of T4 staging prediction before cystectomy.

Main Methods:

• Retrospective cohort study of 118 female BC patients (2017-2021).
• Assessment of T4 stage suspicion via CT, TURBT, and intraoperative evaluation.
• Calculation of frequencies and predictive values for ROPRC potential.

Main Results:

• Only 4 patients (3.4%) underwent ROPRC, all with non-muscle-invasive BC.
• Preoperative T4 staging prediction demonstrated a 99% negative predictive value.
• An estimated 69% of patients undergoing tRC could potentially be candidates for ROPRC.

Conclusions:

• ROPRC is significantly underutilized in female BC patients.
• Accurate preoperative staging supports expanding ROPRC eligibility.
• Increased adoption of ROPRC could enhance functional outcomes for selected patients.