Partial cystectomy: A contemporary review of the Memorial Sloan-Kettering Cancer Center experience and recommendations for patient selection Journal Article

  

Authors:	Holzbeierlein, J. M.; Lopez-Corona, E.; Bochner, B. H.; Herr, H. W.; Donat, S. M.; Russo, P.; Dalbagni, G.; Sogani, P. C.
Article Title:	Partial cystectomy: A contemporary review of the Memorial Sloan-Kettering Cancer Center experience and recommendations for patient selection
Abstract:	Purpose: Partial cystectomy is a bladder sparing procedure that has been used to treat invasive bladder cancer in highly selected patients. This study analyzes the outcomes of partial cystectomy in a contemporary cohort of patients to identify appropriate selection criteria for the procedure. Materials and Methods: Records were reviewed for 58 patients with a primary bladder tumor who had undergone partial cystectomy at Memorial Sloan-Kettering Cancer Center from 1995 to 2001. Information was collected on tumor size, histology, location, presence of carcinoma in situ (CIS), multifocality, neoadjuvant treatment, clinical stage, pathological stage and disease status. Results: For the 58 patients analyzed, overall 5-year survival was 69% with a mean followup of 33 months (range 1 to 83). Of the patients 43 (74%) are alive with an intact bladder, 39 (67%) are currently disease-free with an intact bladder and 32 (55%) have been continuously disease-free with an intact bladder. Seven patients experienced a superficial recurrence and were treated successfully while 15 patients experienced an advanced recurrence. On univariate analysis CIS and multifocality were related to superficial recurrence, and lymph node involvement and positive surgical margin were related to advanced recurrence. On multivariate analysis concomitant CIS (odds ratio 7.05, p = 0.004) and lymph node involvement (odds ratio 4.38, p = 0.031) were predictors of advanced recurrence. Conclusions: In highly selected patients with invasive bladder cancer, partial cystectomy offers acceptable outcomes. Concomitant CIS and presence of metastases to regional lymph nodes predict advanced recurrence.
Keywords:	adolescent; adult; cancer survival; human tissue; treatment outcome; aged; aged, 80 and over; disease-free survival; middle aged; cancer surgery; survival rate; major clinical study; review; cancer recurrence; salvage therapy; advanced cancer; patient selection; cancer adjuvant therapy; neoadjuvant therapy; cancer staging; lymph node metastasis; lymphatic metastasis; cancer grading; tumor localization; neoplasm recurrence, local; tumor volume; risk factors; bladder cancer; prediction; urinary bladder neoplasms; histology; postoperative complications; cancer invasion; cancer center; statistical analysis; minimal residual disease; carcinoma in situ; cystectomy; carcinoma; multivariate analysis; bladder neoplasms; carcinoma, transitional cell; univariate analysis; multiple cancer; positive surgical margin; superficial cancer; memorial sloan kettering cancer center; humans; human; male; female; priority journal; bladder sparing procedure
Journal Title:	Journal of Urology
Volume:	172
Issue:	3
ISSN:	0022-5347
Publisher:	Elsevier Science, Inc.
Date Published:	2004-09-01
Start Page:	878
End Page:	881
Language:	English
DOI:	10.1097/01.ju.0000135530.59860.7d
PROVIDER:	scopus
PUBMED:	15310988
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-4143129953&partnerID=40&md5=07a5259d15d369509e5779aaa12cd96f
Notes:	J. Urol. -- Cited By (since 1996):46 -- Export Date: 16 June 2014 -- CODEN: JOURA -- Source: Scopus

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