Oncological outcomes, quality of life outcomes and complications of partial cystectomy for selected cases of muscle-invasive bladder cancer

To evaluate the oncological results, associated complications, and postoperative health-related quality of life (HR-QoL) in patients treated with partial cystectomy (PC) for muscle-invasive bladder cancer (MIBC).

27 patients who underwent open PC for cT2 MIBC were included. A simple Cox's proportional hazards regression model was used to assess the association of several potential prognostic factors with survival. Postoperative HR-QoL was assessed with the EORTC (European Organisation for the Research and Treatment of Cancer) QLQ-C30 questionnaire version 3.0. Final pathological tumour stages in PC specimen were: pT0: 18.5%, non-MIBC: 3.7%, MIBC: 74.1%, pCIS: 14.8%. Estimated 5-year overall- and progression-free survival rates were 53.7% and 62.1%. Five (18.5%) patients experienced local recurrence with MIBC. Overall, the salvage cystectomy rate was 18.5%. The 90-day mortality rate was 0%. Significant risk factors for progression-free survival were vascular invasion (HR 5.33) and tumour multilocularity (HR 4.5) in the PC specimen, and a ureteric reimplantation during PC (HR 4.53). The rates of intraoperative complications, 30- and 90-day major complications were 7.4%, respectively and 14.8% for overall long-term complications. Postoperatively, median (IQR) global health status and QoL in our PC cohort was 79.2 (52.1-97.9). Open PC can provide adequate cancer control of MIBC with good HR-QoL in highly selected cases. Open PC can lead to long-term bladder preservation and shows an acceptable rate of severe perioperative complications, even in highly comorbid patients.

Scientific reports. 2018 May 30*** epublish ***

Jan Ebbing, Robin Colja Heckmann, Justin William Collins, Kurt Miller, Barbara Erber, Frank Friedersdorff, Tom Florian Fuller, Jonas Busch, Hans Helge Seifert, Peter Ardelt, Christian Wetterauer, Abolfazl Hosseini, Florian Jentzmik, Carsten Kempkensteffen

University Hospital Basel, Urological University Clinic Basel-Liestal, Spitalstrasse 21, 4056, Basel, Switzerland. ., University Hospital Basel, Urological University Clinic Basel-Liestal, Spitalstrasse 21, 4056, Basel, Switzerland., Karolinska Institutet, Department of Molecular Medicine and Surgery (MMK), Karolinska University Hospital, Solna, 171 76, Stockholm, Sweden., Charité - University Hospital, Department of Urology, Chariteplatz 1, 10117, Berlin, Germany., Vivantes Hospital Am Urban, Department of Urology, Dieffenbachstraße 1, 10967, Berlin, Germany., Karolinska University Hospital, Department of Urology, Solna, 171 76, Stockholm, Sweden., Oberschwaben Clinic, Hospital St. Elisabeth, Department of Urology, Elisabethenstr. 15, 88212, Ravensburg, Germany.