Abstract
Involvement of the bladder by colorectal cancer is sufficiently rare to be encountered by an individual surgeon on an infrequent basis. Extirpative procedures for advanced colorectal cancers can involve partial/total bladder resections. In patients without evidence of distant metastatic disease, a reasonable therapeutic effect can be expected when negative surgical margins are obtained. The decision to perform a bladder-sparing procedure or a total pelvic exenteration (TPE) will be based on the extent of the primary lesion as well as patient characteristics. In this study, we report our experience in the management of operable locally advanced colorectal carcinomas involving the urinary bladder. We retrospectively reviewed the hospital records of all patients with advanced colorectal cancer invading the urinary bladder. The age, gender, clinical presentation, physical examination findings, and imaging records were noted. Colonoscopy reports and images were noted and biopsy findings recorded. Similarly, cystoscopy findings and biopsy reports were noted and analyzed. Eight (88%) patients had a primary sigmoid tumor and one (11%) had primary rectal tumor. The clinical staging of the primary tumor was T3 in three (33%) and T4 in six (66%). A biopsy taken during cystoscopy confirmed the malignant lesion in all the nine patients. Four (44%) patients received neoadjuvant chemotherapy with 5-fluorouracil. Eight (88%) patients underwent bladder-sparing resection and the remaining one underwent total pelvic exenteration with ileal conduit for urinary drainage. The mean overall survival was 44 months. The wide spectrum of possible bladder involvement by colorectal cancer requires individual patient-specific and disease-specific approaches. En bloc bladder resection for adherent or invading colorectal cancers achieves good local control and prognosis. The potential for cure in completely excised, node-negative tumors is good. Bladder reconstruction is achievable in most patients.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Gebhardt C, Mayer W, Rukriegel S, Merier U (1999) Multivisceral resection of advanced colorectal carcinoma. Langenbeck's Arch Surg 384:194–199
Eldar S, Kemeny MM, Terz JJ (1985) Extended resections for carcinoma of the colon and rectum. Surg Gynecol Obstet 161(4):319–322
Kobayashi T, Kamoto T, Sugino Y, Takeuchi H, Habuchi T, Ogawa O (2003) High incidence of urinary bladder involvement in carcinomas of the sigmoid and rectum: a retrospective review of 580 patients with colorectal carcinoma. J Surg Oncol 84(4):209–214
Carne PWG, Frye JNR, Kennedy-Smith A et al (2004) Local invasion of the bladder with colorectal cancers: surgical management and patterns of local recurrence. Dis Colon Rectum 47(1):44–47
McKenzie SP, Barnes SL, Schwartz RW (2005) An update on the surgical management of rectal cancer. Curr Surg 62(4):407–411
Balbay MD, Slaton JW, Trane N, Skibber J, Dinney CP (1999) Rationale for bladder-sparing surgery in patients with locally advanced colorectal carcinoma. Cancer 86(11):2212–2216
Weinstein RP, Grob BM, Pachter EM, Soloway S, Fair WR (2001) Partial cystectomy during radical surgery for nonurological malignancy. J Urol 166(1):79–81
Winter DC, Walsh R, Lee G, Kiely D, O’Riordain MG, O’Sullivan GC (2007) Local involvement of the urinary bladder in primary colorectal cancer: outcome with en-bloc resection. Ann Surg Oncol 14(1):69–73
Sasson AR, Sigurdson ER (2000) Management of locally advanced rectal cancer. Surg Oncol 9(4):193–204
Ike H, Shimada H, Yamaguchi S, Ichikawa Y, Fujii S, Ohki S (2003) Outcome of total pelvic exenteration for primary rectal cancer. Dis Colon Rectum 46(4):474–480
Edge SB, Compton CC (2010) The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 17(6):1471–1474
Lehnert T, Methner M, Pollok A, Schaible A, Hinz U, Herfarth C (2002) Multivisceral resection for locally advanced primary colon and rectal cancer: an analysis of prognostic factors in 201 patients. Ann Surg 235(2):217–225
Delacroix SE, Winters JC (2010) Bladder reconstruction and diversion during colorectal surgery. Clin Colon Rectal Surg 23:113–118
Sogni F, Brausi M, Frea B et al (2008) Morbidity and quality of life in elderly patients receiving ileal conduit or orthotopic neobladder after radical cystectomy for invasive bladder cancer. Urology 71(5):919–923
Lowrance WT, Rumohr JA, Clark PE, Chang SS, Smith JA Jr, Cookson MS (2009) Urinary diversion trends at a high volume, single American tertiary care center. J Urol 182(5):2369–2374
Nyam DCNK, Seow-Choen F, Ho MS, Goh HS (1995) Bladder involvement in patients with colorectal carcinoma. Singap Med J 36:525–526
Nerli RB, Reddy M, Koura AC, Prabha V, Ravish IR, Amarkhed S (2008) Cystoscopy assisted laparoscopic partial cystectomy. J Endourol 22:83–86
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Nerli, R.B., Ghagane, S.C., Ram, P. et al. Bladder Invasion in Patients with Advanced Colorectal Carcinoma. Indian J Surg Oncol 9, 547–551 (2018). https://doi.org/10.1007/s13193-018-0788-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13193-018-0788-9