Zhou X, Ji H, Zhang H, Xiong T, Pan J, Chen Z. Treatment and outcomes of urethral recurrence after orthotopic neobladder replacement in patients with bladder cancer - practice in a single centre.
J Int Med Res 2018;
46:3928-3937. [PMID:
29936879 PMCID:
PMC6136033 DOI:
10.1177/0300060518782015]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objectives
To report on the treatment of urethral recurrence after orthotopic urinary
diversion at our institution.
Methods
We retrospectively reviewed clinical information of urethral recurrence in
patients who underwent radical cystectomy and orthotopic urinary diversion
between January 1998 and January 2013.
Results
Of 341 patients, 282 presented for follow-up (median follow-up: 56 months;
range: 1–174 months). Eight patients developed local recurrence of
urothelial cancer after radical cystectomy. The rate of urethral recurrence
(1.4%) in female patients who underwent orthotopic urinary diversion was
lower than in male patients (3.3%). The median (range) time to recurrence
was 33 (6–120) months after radical cystectomy and orthotopic urinary
diversion. Recurrences were treated by transurethral resection of tumour,
urethrectomy, neobladder resection, revision of urinary diversion, adjuvant
chemotherapy, or radiation therapy, based on individual circumstances.
Survival analysis showed that 5-year cancer-specific survival was
significantly higher in patients with urethral recurrence alone (83.3%),
compared with patients with other recurrences, including pelvic/abdomen
recurrence and distant metastasis (26.8%).
Conclusions
En bloc urethrectomy and revision of urinary diversion remain the principle
surgical choices. Selection of transurethral tumour resection was based on
tumour stage and was used in carefully chosen patients. Cancer-specific
survival might depend on multidisciplinary therapy.
Collapse