Risk Factors for Urethral Recurrence in Men After Radical Cystectomy with Orthotopic Urinary Diversion for Urothelial Carcinoma: A Retrospective Cohort Studyopen access
- Authors
- Lee, Dong Hyeon; Song, Wan
- Issue Date
- Aug-2020
- Publisher
- DOVE MEDICAL PRESS LTD
- Keywords
- bladder cancer; neobladder; radical cystectomy; risk factor; urethral recurrence
- Citation
- CANCER MANAGEMENT AND RESEARCH, v.12, pp 6739 - 6746
- Pages
- 8
- Indexed
- SCIE
SCOPUS
- Journal Title
- CANCER MANAGEMENT AND RESEARCH
- Volume
- 12
- Start Page
- 6739
- End Page
- 6746
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/6942
- DOI
- 10.2147/CMAR.S260979
- ISSN
- 1179-1322
- Abstract
- Purpose: To evaluate the risk factors affecting urethral recurrence (UR) in men after radical cystectomy (RC) with ileal orthotopic neobladder (IONB). Materials and Methods: We retrospectively reviewed 348 men who underwent RC with IONB for bladder cancer between January 2010 and December 2017. Clinicopathologic characteristics, including tumor location (trigone and/or bladder neck), prostatic urethral and/or stromal involvement, presence of carcinoma in situ (CIS), pathologic T and N stage, and urethral resection margin status, were identified. Kaplan Meier survival analysis was used to illustrate urethral recurrence-free survival (URFS), and Cox proportional hazard models were applied to identify factors predicting UR. Results: Of the 348 patients, UR was identified in 7 (2.0%) patients during the mean followup of 33.3 months. The 2-, 3-, and 5 -year URFS rates were 97.6%, 96.3%, and 93.8%, respectively. On multivariable analysis, prostatic urethral involvement (P = 0.033, hazard ratio: 6.25, 95% confidence interval: 1.06-36.96) was an independent predictor of UR. When patients were divided according to prostatic urethral involvement (negative vs positive), the 2- and 3 -year URFS rates were significantly different (93.8% and 96.8%, respectively, vs 92.0% and 92.0%, respectively; P = 0.020). All 7 patients with UR underwent transurethral surgery and maintained their IONB. Conclusion: In this series, UR occurred in approximately 2% of men after RC with IONB. Prostatic urethral involvement was the only significant prognostic factor for UR. Follow-up strategies considering UR risk should be adopted to facilitate early detection in those at high risk of UR.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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