1605 RISK FACTORS FOR UPPER URINARY TRACT AND URETHRAL RECURRENCES AFTER RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive1 Apr 20111605 RISK FACTORS FOR UPPER URINARY TRACT AND URETHRAL RECURRENCES AFTER RADICAL CYSTECTOMY Polat Turker, Peter J. Bostrom, Marcelo L. Wroclawski, Tuomas Mirtti, Martti Nurmi, Neil E. Fleshner, Antonio Finelli, Michael A. Jewett, and Alexandre R. Zlotta Polat TurkerPolat Turker Toronto, Canada More articles by this author , Peter J. BostromPeter J. Bostrom Toronto, Canada More articles by this author , Marcelo L. WroclawskiMarcelo L. Wroclawski Toronto, Canada More articles by this author , Tuomas MirttiTuomas Mirtti Helsinki, Finland More articles by this author , Martti NurmiMartti Nurmi Turku, Finland More articles by this author , Neil E. FleshnerNeil E. Fleshner Toronto, Canada More articles by this author , Antonio FinelliAntonio Finelli Toronto, Canada More articles by this author , Michael A. JewettMichael A. Jewett Toronto, Canada More articles by this author , and Alexandre R. ZlottaAlexandre R. Zlotta Toronto, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2710AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recurrences in the upper urinary tract (UUTrec) and urethra (urethrec) following radical cystectomy (RC) for transitional cell carcinoma of the bladder are often recognized after symptomatic presentation and impact patient's survival. Accurate predictive risk factors would aid in designing individually tailored follow-up (FU) protocols. METHODS 635 consecutive patients undergoing RC for urothelial BC without neoadjuvant chemotherapy at University Health Network, Toronto, Canada (1992–2008) and University of Turku, Turku, Finland (1986–2005) were studied. The rates of UUT and urethral recurrences were analyzed. Patients with urethrectomy were excluded from urethral recurrences analysis. Clinicopathological variables associated with recurrence were evaluated using the fÓ2-test. The Kaplan-Meier method was used to analyze survival. RESULTS Mean FU was 45 months (0–264). Among the 635 RC patients, 22(3%) had an UUT recurrence and among the 559 patients without urethrectomy during RC 17(3%) suffered from a urethral recurrence. Median time to UUTrec was 20 months (3–84 mo) and to urethrec was 30 months (10–96 mo). Male gender (p=0.035), T2 or higher primary stage (0.014), concomitant CIS (p=0.014) and prostatic urethra involvement (p=0.021) were significant risk factors for UUTrec. T2 or higher primary stage (p=0.001), pathological stage higher than T2 (p=0.03) and prostatic urethra involvement (p=0.05) were significant risk factors for urethral recurrence. Disease specific and overall survival of UUTrec were poorer than urethrec (43 vs 74% at 10 years, p=0.047). CONCLUSIONS The risk of UUT or urethral recurrence is relatively low after RC when selection of patients has been performed prior to surgery. Efforts should be made to recognise prostatic urethra involvement and presence of CIS prior to RC. We found that patients with urethral recurrence had lower mortality rates than described in some previous series and may be often salvaged but both UTCC and urethral recurrences remain challenging to manage. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e644 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Polat Turker Toronto, Canada More articles by this author Peter J. Bostrom Toronto, Canada More articles by this author Marcelo L. Wroclawski Toronto, Canada More articles by this author Tuomas Mirtti Helsinki, Finland More articles by this author Martti Nurmi Turku, Finland More articles by this author Neil E. Fleshner Toronto, Canada More articles by this author Antonio Finelli Toronto, Canada More articles by this author Michael A. Jewett Toronto, Canada More articles by this author Alexandre R. Zlotta Toronto, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...