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- Title
Treatment and Outcomes of Urethral Recurrence of Urinary Bladder Cancer in Women after Radical Cystectomy and Orthotopic Neobladder: A Series of 12 Cases.
- Authors
Hrbáček, Jan; Macek, Petr; ali-El-Dein, Bedeir; Thalmann, George N.; Stenzl, arnulf; Babjuk, Marek; Shaaban, atallah a.; Gakis, Georgios
- Abstract
Introduction: The incidence, treatment, and outcome of urethral recurrence (UR) after radical cystectomy (RC) for muscle-invasive bladder cancer with orthotopic neobladder in women have rarely been addressed in the literature. Patients and Methods: A total of 12 patients (median age at recurrence: 60 years) who experienced UR after RC with an orthotopic neobladder were selected for this study from a cohort of 456 women from participating institutions. The primary clinical and pathological characteristics at RC, including the manifestation of the UR and its treatment and outcome, were reviewed. Results: The primary bladder tumors in the 12 patients were urothelial carcinoma in 8 patients, squamous cell carcinoma and adenocarcinoma in 1 patient each, and mixed histology in 2 patients. Three patients (25%) had lymph node-positive disease at RC. The median time from RC to the detection of UR was 8 months (range 4-55). Eight recurrences manifested with clinical symptoms and 4 were detected during follow-up or during a diagnostic work-up for clinical symptoms caused by distant metastases. Treatment modalities were surgery, chemotherapy, radiotherapy, and bacillus Calmette-Guérin urethral instillations. Nine patients died of cancer. The median survival after the diagnosis of UR was 6 months. Conclusions: UR after RC with an orthotopic neobladder in females is rare. Solitary, noninvasive recurrences have a favorable prognosis when detected early. Invasive recurrences are often associated with local and distant metastases and have a poor prognosis. © 2014 S. Karger AG, Basel
- Subjects
BLADDER cancer treatment; CYSTECTOMY; DISEASES in women; ADENOCARCINOMA; HEALTH outcome assessment; DISEASE relapse; DISEASE incidence
- Publication
Urologia Internationalis, 2015, Vol 94, Issue 1, p45
- ISSN
0042-1138
- Publication type
Article
- DOI
10.1159/000363112