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Abstract

We thank Herr for his important comments on our study. We agree that some important information is unavailable in the Surveillance, Epidemiology, and End Results (SEER) database, which precluded us from including it in the analyses. For example, information on the extent of carcinoma in situ, previous intravesical therapy, as well as neoadjuvant or adjuvant chemotherapy was not provided in the SEER database. It is true that neoadjuvant chemotherapy significantly prolongs survival. For example, in the study by Grossman et al, 1 Grossman H.B. Natale R.B. Tangen C.M. et al. Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med. 2003; 349: 859-866 Crossref PubMed Scopus (1975) Google Scholar a 31-month median survival benefit was observed when neoadjuvant chemotherapy was administered in comparison with cystectomy alone. Despite the unavailability of some information within the SEER database, this tumor registry represents a valuable resource for the assessment of population-based trends in the rate of cystectomy use and of associated survival. We hope that it provides more than a fragmented and distorted vision of the reality. Editorial CommentUrologyVol. 74Issue 4PreviewIt is well known that the outcome of invasive bladder cancer is determined more by the extent of disease (stage) than by the extent (type) of surgery. This helps to explain similar survival results after transurethral resection alone, partial cystectomy, or radical cystectomy. To cure invasive bladder cancer, removal of the tumor with negative surgical margins is required,1 regardless of the procedure used. Because not all tumors can be cured with any approach, the “silent partner” driving outcomes is case selection. Full-Text PDF Partial Cystectomy Does Not Undermine Cancer Control in Appropriately Selected Patients With Urothelial Carcinoma of the Bladder: A Population-based Matched AnalysistUrologyVol. 74Issue 4PreviewCancer control outcomes after partial cystectomy (PC) are not well studied. We compared the population-based rates of overall (OS) and cause-specific survival (CSS) in patients with urothelial carcinoma of the urinary bladder (UCB) treated with PC or radical cystectomy (RC). Full-Text PDF