Anterior urethra sparing cystoprostatectomy for bladder cancer: a 10-year, single center experience

Decision making regarding the urethra before and after radical cystectomy due to urothelial carcinoma has always been controversial. To determine whether anterior urethra sparing cystoprostatectomy for bladder cancer is an oncologically-safe procedure, we evaluated the long-term oncologic clinical outcome.

A total of 51 male patients with cTa-4N0-2M0 bladder cancer were treated with anterior urethra sparing cystoprostatectomy and simultaneous urinary diversion between 2000 and 2013, and underwent follow up for 4 months or more We assessed differences in the perioperative outcomes, oncologic outcomes and recurrence rates according to the urinary diversion

The median patient age and follow-up period were 66 years and 35 months, respectively The 5- and 10-year recurrence free survival (RFS) rates in ileal conduit (IC) group vs orthotopic neobladder reconstruction (NB) group were 45 0 and 20 3% vs 39 3 and 19 6%, respectively Likewise, the 5- and 10-year disease specific survival (DSS) were 52 7 and 32 1% vs 39 3 and 29 5%, respectively Multivariate analysis revealed two independent prognostic factors for RFS and DSS, including age at surgery and lymph node status Local recurrence in the remnant anterior urethra occurred in only 1 patient (2 0%) at 57 months after surgery

Our long-term data show that anterior urethra sparing cystoprostatectomy is an oncologically-safe procedure regardless of the type of urinary diversion in a subset of carefully selected patients with bladder cancer without evidence of urothelial carcinoma in the urethra/bladder neck and urethral surgical margin

SpringerPlus 2015 Aug 08*** epublish ***

Nozomi Hayakawa, Nobuyuki Kikuno, Hiroki Ishihara, Osamu Ryoji, Kazunari Tanabe

Department of Urology, Saiseikai Kawaguchi General Hospital, Nishikawaguchi, Kawaguchi, Saitama Japan ; Department of Urology, Tokyo Women's Medical University, Shinjyuku-ku, Tokyo, Japan , Department of Urology, Saiseikai Kawaguchi General Hospital, Nishikawaguchi, Kawaguchi, Saitama Japan ; Department of Urology, Tokyo Women's Medical University, Shinjyuku-ku, Tokyo, Japan , Department of Urology, Saiseikai Kawaguchi General Hospital, Nishikawaguchi, Kawaguchi, Saitama Japan ; Department of Urology, Tokyo Women's Medical University, Shinjyuku-ku, Tokyo, Japan , Department of Urology, Saiseikai Kawaguchi General Hospital, Nishikawaguchi, Kawaguchi, Saitama Japan ; Department of Urology, Tokyo Women's Medical University, Shinjyuku-ku, Tokyo, Japan , Department of Urology, Tokyo Women's Medical University, Shinjyuku-ku, Tokyo, Japan

PubMed     Full Text Article