Radical cystectomy (RC) with pelvic lymph node dissection is the standard treatment for muscle invasive bladder cancer and the oncologic outcomes following it are directly related to disease pathology and surgical technique. Therefore, we sought to analyze these features in a cohort from a Brazilian tertiary oncologic center and try to identify those who could negatively impact on the disease control.
We identified 128 patients submitted to radical cystectomy, for bladder cancer treatment, from January 2009 to July 2012 in one oncology tertiary referral public center (Mario Penna Institute, Belo Horizonte, Brazil). We retrospectively analyzed the findings obtained from their pathologic report and assessed the complications within 30 days of surgery.
We showed similar pathologic and surgical findings compared to other large series from the literature, however our patients presented with a slightly higher rate of pT4 disease. Positive surgical margins were found in 2/128 patients (1.5%). The médium number of lymph nodes dissected were 15. Major complications (Clavien 3 to 5) within 30 days of cystectomy occurred in 33/128 (25.7%) patients.
In the management of invasive bladder cancer, efforts should focus on proper disease diagnosis and staging, and, thereafter, correct treatment based on pathologic findings. Furthermore, extended LND should be performed in all patients with RC indication. A critical analysis of our complications in a future study will help us to identify and modify some of the factors associated with surgical morbidity.
International braz j urol : official journal of the Brazilian Society of Urology. 0000 [Epub]
Renato B Corradi, Gustavo Jaime Climaco Galvao, Gabriel M Oliveira, Vinicius F Carneiro, Wadson Gomes Miconi, Paulo Guilherme Oliveira Salles, Walter Luiz Ribeiro Cabral, Carlos Corradi, Andre Lopes Lopes Salazar
Departamento de Urologia, Intituto Mario Penna, Belo Horizonte, MG, Brasil., Departamento de Urologia, Intituto Mario Penna, Belo Horizonte, MG, Brasil., Departamento de Urologia, Intituto Mario Penna, Belo Horizonte, MG, Brasil., Departamento de Urologia, Intituto Mario Penna, Belo Horizonte, MG, Brasil., Departamento de Urologia, Intituto Mario Penna, Belo Horizonte, MG, Brasil., Departamento de Urologia, Intituto Mario Penna, Belo Horizonte, MG, Brasil., Departamento de Urologia, Intituto Mario Penna, Belo Horizonte, MG, Brasil., Departamento de Urologia, Hospital das Clínicas UFMG, Belo Horizonte, MG, Brasil., Departamento de Urologia, Intituto Mario Penna, Belo Horizonte, MG, Brasil.