You have accessJournal of UrologyBladder Cancer: Invasive I1 Apr 20121404 SUBSTANTIAL PELVIC RECURRENCE(PR) RATES AFTER CONTEMPORARY RADICAL CYSTECTOMY (RC) FOR PT3/4 N0-2 TRANSITIONAL BLADDER CANCER(TBC): A MULTIINSTITUTIONAL CANADIAN STUDY Libni Eapen, Rodney Breau, Eric Belanger, and Scott Morgan Libni EapenLibni Eapen Ottawa, Canada More articles by this author , Rodney BreauRodney Breau Ottawa, Canada More articles by this author , Eric BelangerEric Belanger Ottawa, Canada More articles by this author , and Scott MorganScott Morgan Ottawa, Canada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1855AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The risk of developing PR either alone,or in addition to distant metastases(DM) following RC for pT3/4 TBC is not well characterized. This is due to inconsistent pelvic imaging in patients with recurrent cancer post RC, especially once distant metastases develop. Our objective was to determine the risk of PR in patients undergoing contemporary RC for pT3/4 TBC across Canada. METHODS Canadian academic cancer centres were solicited to contribute to the study which is an individual case audit of a sample of RC done at each institution. At each center a urologist,radiation oncologist and pathologist reviewed the cases.The pathologist generated a list of all RC done IN SEQUENCE starting Jan 1/2005.In order to avoid selection bias the first 10 consecutive patients (pts) meeting the following selection criteria were submitted REGARDLESS of wether PR status was known: pT3/4 N0-2 M0 TBC and no preop or adjuvant XRT. Neo or adjuvant chemo was permitted. Collected data included: age, date of RC, stage, #nodes, date of last follow up, and status (no PR, PR only, PR and DM, DM only, or pelvic status unknown) Kaplan Meier actuarial risks of pelvic recurrence (ARPR) were calculated. RESULTS Nine centres from six provinces provided data on 105 pts. Age range 43.2-91.4 Mean/Median 68.7/69.9 years.T stage was pT3=76 (pT3a=36, pT3b=39, PT3NOS=1) and pT4=29 (pT4a=26, pT4b=2, pT4NOS=1). N stage was N0=57, N1=14, N2=26 and Nx=8. # nodes dissected ranged from 0-67 with Mean/Median = 12/11. >15 nodes=29.8%, 11-15=20.2%, 6-10=23.1% and 26.9% =5 or less. Followup: range 0.2-74.6 months, median=13.1. 37 pts had PR, 52 pts had no PR and pelvic status was unknown in 16pts but were considered to have no PR. Of the 37 pts with PR 24 also developed DM and 13 had only PR. At 2 years the ARPR was: all 105 pts= 51% (95%CI 38-63%), pT3 pts=50% (95% CI 36-64%), pT3a=40% pT3b=68%, pT4 pts=54% (95% CI 29-80%), pT4a=55% pT4b=50%. CONCLUSIONS Patients with pT3/4 N0-2 TBC have a high rate of PR after RC and major node dissection. Whilst pelvic tumor eradication may not be sufficient to cure a patient (owing to DM) it is nevertheless necessary whenever cure is sought.Increasing the cure rate in these pts requires both better treatment of systemic distant metastases and improved pelvic tumor control. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e570 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Libni Eapen Ottawa, Canada More articles by this author Rodney Breau Ottawa, Canada More articles by this author Eric Belanger Ottawa, Canada More articles by this author Scott Morgan Ottawa, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...