Partial Cystectomy for Pure and Variant Urothelial Carcinoma



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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.





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