Practice patterns and recurrence after partial cystectomy for bladder cancer
- 196 Downloads
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.
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).
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.
KeywordsUrinary bladder neoplasms Partial cystectomy Radical cystectomy Practice patterns Lymphadenectomy
Conflict of interest statement
There is no conflict of interest.
- 1.Canadian Cancer Society (2008) National Cancer Institute of Canada, Statistics Canada, Provincial/Territorial Cancer Registries, Public Health Agency of Canada. Canadian Cancer StatisticsGoogle Scholar
- 4.Rutledge RH (1995) Theodore Billroth: a century later. Surgery 118:36–43Google Scholar
- 5.Sonnenburg E (1882) Erste ausgedehnte Resection der Harnblase wegen Sarcoms. Chir KongrGoogle Scholar
- 22.Jardin A, Vallancien G (1984) Partial cystectomy for bladder tumours. Prog Clin Biol Res 162A:375–385Google Scholar
- 28.Jankowski JT, Cherullo EE, Steinway ML, Feng AH (2008) Cystectomy, Partial. In: Ghoniem GM, Talavera F, Wolf JS, Schwartz BF (eds) eMedicine from WebMDGoogle Scholar