Partial Cystectomy for Pure and Variant Urothelial Carcinoma
Stechnolock: Journal of Cancer Research
Purpose: Evaluation of outcomes for those who undergo partial cystectomy (PC) for the management of select patients with bladder cancer (BC).
Materials and Methods: We performed a retrospective review of consecutive open PCs with lymph node dissection performed by a single surgeon between 2000 and 2018 for BC. Patients were identified via the surgeon’s documented case logs. Patients had either a cT2 solitary tumor (N=35), a high-grade (HG) tumor in a diverticulum (N=8), or a HG solitary cT1 lesion concerning for more advanced disease (N=10).
Results: 53 patients had primary urothelial carcinoma (UC), including 18 with variant UC histologies on pre-operative biopsy. Patients had an average of 55 months (range 2-188 months) of follow-up. 37 were male (70%). The median age at the time of PC was 71 years (range 48-90). Pathology specimens at PC revealed 19 as pT0, 9 as pTis-pT1, 6 as pT2 and 19 as pT3. 7 patients died from metastatic BC (1 with pT0 and 6 with pT3 pathology at PC); none had an intravesical recurrence. 12 patients had intravesical recurrences of UC (23%), 11 of whom had a non-MI recurrence managed endoscopically and with intravesical therapies. The 5-year cumulative incidence of BC specific deaths by pathologic stage was: 8% (95% CI 0.4-32.8%) for pT0, 0% for pTis-pT1, 0% for pT2, and 32% (95% CI 12.4-52.9%) for pT3. BC specific death was not significantly changed by the presence of variant UC on pre-operative biopsy.
Conclusion: PC appears to provide oncologically acceptable outcomes in patients who present with solitary UC lesions with pure or variant histologies with tumors amenable to PC.
Osinski, T. L., Campbell, T., Gantz, J., Nelson, B. J., Miyamoto, H., Feng, C., & Messing, E. (2022). Partial Cystectomy for Pure and Variant Urothelial Carcinoma. Stechnolock: Journal of Cancer Research, 1 (1) Retrieved from https://scholar.rochesterregional.org/rrhpubs/1679