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World Journal of Urology

, Volume 28, Issue 4, pp 419–423 | Cite as

Practice patterns and recurrence after partial cystectomy for bladder cancer

  • Nader Fahmy
  • Armen Aprikian
  • Simon Tanguay
  • Salaheddin M. Mahmud
  • Mohammed Al-Otaibi
  • Suganthiny Jeyaganth
  • Moamen Amin
  • Wassim KassoufEmail author
Original Article

Abstract

Purpose

Partial cystectomy (PC) remains a viable alternative to radical cystectomy (RC) for management of invasive bladder cancer in approximately 5% of patients. We used a population-based database to examine practice patterns and recurrence after partial cystectomy.

Materials and methods

We obtained billing records of all partial and radical cystectomies performed for bladder cancer in Quebec from 1983 until 2005. Analysis included age, gender, year of surgery, surgeon’s age, hospital type, preoperative and postoperative visits with accompanying diagnoses and dates of recurrences salvage RC, and death.

Results

A total of 714 (30.4%) patients with invasive bladder cancer underwent PC. Majority of PC (65%) were performed in non-academic institutions. Pelvic lymphadenectomy was performed in only 163 patients (23%) and concomitant ureteral reimplantation was performed in 89 patients (13%). Of 714 patients, 52 (23.7%) required a salvage RC. Median time from PC to salvage RC was 17.6 months (range 1–240 months), respectively. Patients who underwent PC had similar 5-year overall survival compared with patients who underwent upfront RC (49.8% vs. 51%, p = 0.21).

Conclusions

Rate of PC for invasive bladder cancer is significantly higher than expected. Pelvic lymphadenectomy is underutilized in bladder cancer patients treated with PC. Whether prevalent use of PC is due to less stringent selection criteria remains unknown. Since late recurrence is not uncommon, lifelong follow-up is recommended.

Keywords

Urinary bladder neoplasms Partial cystectomy Radical cystectomy Practice patterns Lymphadenectomy 

Notes

Conflict of interest statement

There is no conflict of interest.

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Nader Fahmy
    • 1
  • Armen Aprikian
    • 1
  • Simon Tanguay
    • 1
  • Salaheddin M. Mahmud
    • 1
  • Mohammed Al-Otaibi
    • 1
  • Suganthiny Jeyaganth
    • 1
  • Moamen Amin
    • 1
  • Wassim Kassouf
    • 1
    • 2
    Email author
  1. 1.Department of Surgery (Urology)McGill UniversityMontrealCanada
  2. 2.Department of UrologyThe Montreal General HospitalMontrealCanada

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