You have accessJournal of UrologyBladder Cancer: Invasive/Metastatic Disease III1 Apr 20101825 CLINICAL OUTCOME IN PATIENTS WITH PT4 UROTHELIAL CARCINOMA AT RADICAL CYSTECTOMY Oliver Reich, Derya Tilki, Robert Svatek, Pierre Karakiewicz, Hendrik Isbarn, Wassim Kassouf, Yves Fradet, Giacomo Novara, Hans-Martin Fritsche, Patrick Bastian, Jonathan Izawa, Vincenzo Ficarra, Seth Lerner, Mark Schoenberg, Colin Dinney, Eila Skinner, Yair Lotan, Arthur Sagalowsky, Christian Stief, and Shahrokh Shariat Oliver ReichOliver Reich Munich, Germany More articles by this author , Derya TilkiDerya Tilki Munich, Germany More articles by this author , Robert SvatekRobert Svatek Dallas, TX More articles by this author , Pierre KarakiewiczPierre Karakiewicz Montréal, Canada More articles by this author , Hendrik IsbarnHendrik Isbarn Montréal, Canada More articles by this author , Wassim KassoufWassim Kassouf Montréal, Canada More articles by this author , Yves FradetYves Fradet Quebec City, Canada More articles by this author , Giacomo NovaraGiacomo Novara Padua, Italy More articles by this author , Hans-Martin FritscheHans-Martin Fritsche Regensburg, Germany More articles by this author , Patrick BastianPatrick Bastian Bonn, Germany More articles by this author , Jonathan IzawaJonathan Izawa London, Canada More articles by this author , Vincenzo FicarraVincenzo Ficarra Padua, Italy More articles by this author , Seth LernerSeth Lerner Houston, TX More articles by this author , Mark SchoenbergMark Schoenberg Baltimore, MD More articles by this author , Colin DinneyColin Dinney Houston, TX More articles by this author , Eila SkinnerEila Skinner Los Angeles, CA More articles by this author , Yair LotanYair Lotan Dallas, TX More articles by this author , Arthur SagalowskyArthur Sagalowsky Dallas, TX More articles by this author , Christian StiefChristian Stief Munich, Germany More articles by this author , and Shahrokh ShariatShahrokh Shariat Dallas, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1763AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To describe the cancer-specific outcomes of patients with pathologic T4 (pT4) urothelial carcinoma of the bladder (UCB) at radical cystectomy in a large international cohort of patients. METHODS The records of 4257 patients treated with radical cystectomy for UCB at twelve centres were reviewed. None of the patients received any pre-operative systemic chemotherapy or radiotherapy. RESULTS Of the 4257 patients, 583 (14%) had pT4 UCB: 83.7% were of male gender; 85.2% had substage pT4a; 24.9% had positive soft tissue surgical margin (STSM); 57.8% had lymphovascular invasion (LVI); and 53.5% had lymph node metastasis. Median follow-up was 55.0 months. Overall five-year recurrence-free and cancer-specific survival estimates were 29% (95% CI: 22-32) and 31% (95% CI: 25-36), respectively. In multivariable analyses, female gender (p=0.005 and p=0.001, respectively), positive STSM (p=0.014 and p<0.001, respectively), LVI (p=0.016 and p=0.005, respectively), pT4b substage (p=0.041 and p=0.002, respectively) and lymph node involvement (p<0.001 and p<0.001, respectively) were independently associated with disease recurrence and cancer-specific mortality. CONCLUSIONS Patients with pT4 UCB have a highly variable outcome. Features associated with metastatic tumor dissemination (i.e., LNI and LVI) and local disease burden (i.e. STSM and pT4 substage) are associated with poor outcomes in patients with pT4 UCB. Further research is needed to understand why female patients with pT4 UCB have a worse outcome than their male counterparts. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e708 Peer Review Report Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Oliver Reich Munich, Germany More articles by this author Derya Tilki Munich, Germany More articles by this author Robert Svatek Dallas, TX More articles by this author Pierre Karakiewicz Montréal, Canada More articles by this author Hendrik Isbarn Montréal, Canada More articles by this author Wassim Kassouf Montréal, Canada More articles by this author Yves Fradet Quebec City, Canada More articles by this author Giacomo Novara Padua, Italy More articles by this author Hans-Martin Fritsche Regensburg, Germany More articles by this author Patrick Bastian Bonn, Germany More articles by this author Jonathan Izawa London, Canada More articles by this author Vincenzo Ficarra Padua, Italy More articles by this author Seth Lerner Houston, TX More articles by this author Mark Schoenberg Baltimore, MD More articles by this author Colin Dinney Houston, TX More articles by this author Eila Skinner Los Angeles, CA More articles by this author Yair Lotan Dallas, TX More articles by this author Arthur Sagalowsky Dallas, TX More articles by this author Christian Stief Munich, Germany More articles by this author Shahrokh Shariat Dallas, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...