Does partial cystectomy compromise oncologic outcomes for patients with bladder cancer compared to radical cystectomy? A matched case-control analysis

John J. Knoedler, Stephen A. Boorjian, Simon P. Kim, Christopher J. Weight, Prabin Thapa, Robert F. Tarrell, John C. Cheville, Igor Frank

Research output: Contribution to journalArticlepeer-review

69 Scopus citations

Abstract

Purpose: To our knowledge long-term oncologic outcomes following partial cystectomy for urothelial carcinoma remain to be defined. We evaluated patterns of recurrence and survival among matched patients treated with partial vs radical cystectomy for bladder cancer. Materials and Methods: We identified 86 patients who underwent partial cystectomy for pT1-4N0-1Mx urothelial carcinoma between 1980 and 2006 at our institution. They were matched 1:2 to patients undergoing radical cystectomy based on age, gender, pathological T stage and receipt of neoadjuvant chemotherapy. Survival was estimated using Kaplan-Meier analysis and compared with the log rank test. Results: Median postoperative followup was 6.2 years (range 0 to 27). No difference was noted for 10-year distant recurrence-free survival (61% vs 66%, p = 0.63) or cancer specific survival (58% vs 63%, p = 0.67) between patients treated with partial and radical cystectomy, respectively. Interestingly, 4 of 86 patients (5%) who underwent partial cystectomy showed extravesical pelvic tumor recurrence postoperatively vs 29 of 167 (17%) who underwent radical cystectomy (p = 0.004). In addition, 33 of 86 patients (38%) were diagnosed with intravesical recurrence of tumor after partial cystectomy and 16 of 86 (19%) initially treated with partial cystectomy ultimately underwent radical cystectomy. Conclusions: Our matched analysis demonstrated no difference in metastasis-free or cancer specific survival between select patients undergoing partial cystectomy and those undergoing radical cystectomy. Nevertheless, patients treated with partial cystectomy remain at risk for intravesical recurrence and, thus, they should be counseled and surveilled accordingly.

Original languageEnglish (US)
Pages (from-to)1115-1119
Number of pages5
JournalJournal of Urology
Volume188
Issue number4
DOIs
StatePublished - Oct 2012
Externally publishedYes

Keywords

  • carcinoma
  • cystectomy
  • local
  • neoplasm recurrence
  • urinary bladder
  • urothelium

Fingerprint

Dive into the research topics of 'Does partial cystectomy compromise oncologic outcomes for patients with bladder cancer compared to radical cystectomy? A matched case-control analysis'. Together they form a unique fingerprint.

Cite this