MP55-06 PROSTATE SPARING CYSTECTOMY: 20 YEARS SINGLE CENTER EXPERIENCE

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive II1 Apr 2014MP55-06 PROSTATE SPARING CYSTECTOMY: 20 YEARS SINGLE CENTER EXPERIENCE Laura Mertens, Richard Meijer, Remco de Vries, Jakko Nieuwenhuijzen, Henk van der Poel, Axel Bex, Bas van Rhijn, Wim Meinhardt, and Simon Horenblas Laura MertensLaura Mertens More articles by this author , Richard MeijerRichard Meijer More articles by this author , Remco de VriesRemco de Vries More articles by this author , Jakko NieuwenhuijzenJakko Nieuwenhuijzen More articles by this author , Henk van der PoelHenk van der Poel More articles by this author , Axel BexAxel Bex More articles by this author , Bas van RhijnBas van Rhijn More articles by this author , Wim MeinhardtWim Meinhardt More articles by this author , and Simon HorenblasSimon Horenblas More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1554AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Radical cystoprostatectomy (RC) is the standard treatment for men with muscle invasive bladder cancer (MIBC) or refractory high risk non-MIBC. With removal of the prostate and seminal vesicals, there is a very high probability of loss of normal sexual function. Prostate sparing cystectomy (PSC) has been introduced as a modification of standard RC for selected males with bladder cancer (BC), leaving the prostate, seminal vesicles and prostatic urethra in situ. The goal of PSC is to improve functional results without jeopardizing oncological results. In the present study, we evaluated the long-term oncological and functional results after PSC for BC, starting 20 years ago. Methods Between 1994 and 2013, 120 patients with cT1-4N0-3 BC were treated with PSC. One hundred and ten patients had a follow up of ≥2 years and were eligible for analysis. In order to rule out tumour in the bladder neck and/or prostatic urethra, all patients had undergone preoperative transurethral biopsy of the bladder neck and prostatic urethra as well as prostate specific antigen measurement and transrectal ultrasound with biopsies, to rule out prostate cancer. We assessed oncological outcome (disease specific survival (DSS) and recurrence free survival (RFS); recurrence rates, prostate cancer and functional results (continence, voiding, erectile and ejaculatory function). Results Mean age of the patients was 56.2 years (standard deviation: 8.3 years). The median follow up was 77.0 months (interquartile range: 57-116 months). The 2- and 5-year DSS rates were 76.2% and 66.5%, respectively, and the 2- and 5-year RFS rates 71.2% and 66.6%. The total distant recurrence rate was 34.2% and the local recurrence rate 10.0%. One of the local recurrences was in the remnant prostatic urothelium. Prostate cancer was diagnosed in 2.7% of the patients. Complete daytime and nighttime continence was achieved in 96.2% and 81.9%, respectively. Erectile function and antegrade ejaculation could be maintained in 89.7% and 36.0% of the patients, respectively. Conclusions Our long-term data show that, for a subset of carefully selected BC patients with no evidence of urothelial carcinoma in the prostatic urethra/bladder neck and no prostate cancer, PSC is an oncologically safe procedure with excellent functional results. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e557 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Laura Mertens More articles by this author Richard Meijer More articles by this author Remco de Vries More articles by this author Jakko Nieuwenhuijzen More articles by this author Henk van der Poel More articles by this author Axel Bex More articles by this author Bas van Rhijn More articles by this author Wim Meinhardt More articles by this author Simon Horenblas More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...