TY - JOUR
T1 - Outcomes of Radical Cystectomy for Transitional Cell Carcinoma of the Bladder
T2 - A Contemporary Series From the Bladder Cancer Research Consortium
AU - Shariat, Shahrokh F.
AU - Karakiewicz, Pierre I.
AU - Palapattu, Ganesh S.
AU - Lotan, Yair
AU - Rogers, Craig G.
AU - Amiel, Gilad E.
AU - Vazina, Amnon
AU - Gupta, Amit
AU - Bastian, Patrick J.
AU - Sagalowsky, Arthur I.
AU - Schoenberg, Mark P.
AU - Lerner, Seth P.
N1 - Funding Information:
Supported by the Austrian Program for Advanced Research and Treatment (SFS), Fonds de la Recherche en Santé du Québec (PIK) and the AFUD/AUAER Research Scholar Program (GSP).
Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2006/12
Y1 - 2006/12
N2 - Purpose: We present the characteristics and outcomes of a large, contemporary, consecutive series of patients treated with radical cystectomy and pelvic lymphadenectomy for transitional cell carcinoma of the bladder. Materials and Methods: We developed a multi-institutional database and collected retrospective and prospective data on 888 consecutive patients with bladder transitional cell carcinoma who were treated with radical cystectomy and pelvic lymphadenectomy at 3 academic centers in the United States between 1984 and 2003. Results: Of the patients 25% had extravesical tumor extension with negative lymph nodes and 23% had lymph node metastasis. The rate of lymph node involvement increased with advancing pathological stage. Mean recurrence-free and bladder cancer specific survival ± SE was 58% ± 2% and 66% ± 2% at 5 years, respectively. On preoperative multivariate analysis clinical tumor stage and neoadjuvant systemic chemotherapy were associated with cancer recurrence, while more advanced age, clinical tumor stage and preoperative carcinoma in situ were associated with bladder cancer specific mortality. On postoperative multivariate analysis pathological tumor stage, lymph node metastasis, lymphovascular invasion, adjuvant radiotherapy and adjuvant chemotherapy were associated with cancer recurrence, while higher pathological tumor stage, more advanced age, lymph node metastasis, lymphovascular invasion and adjuvant radiotherapy were associated with disease specific survival. Patients with metastasis to regional lymph nodes (pT any N1-3) were at significantly higher risk for bladder cancer recurrence and death than patients with extravesical tumor extension (pT3N0), who in turn were at significantly higher risk than patients with organ confined disease (pT2 N0 or less). Conclusions: The results of this large, contemporary, multi-institutional series show that radical cystectomy and pelvic lymphadenectomy provide durable local control and disease specific survival in patients with localized invasive transitional cell carcinoma.
AB - Purpose: We present the characteristics and outcomes of a large, contemporary, consecutive series of patients treated with radical cystectomy and pelvic lymphadenectomy for transitional cell carcinoma of the bladder. Materials and Methods: We developed a multi-institutional database and collected retrospective and prospective data on 888 consecutive patients with bladder transitional cell carcinoma who were treated with radical cystectomy and pelvic lymphadenectomy at 3 academic centers in the United States between 1984 and 2003. Results: Of the patients 25% had extravesical tumor extension with negative lymph nodes and 23% had lymph node metastasis. The rate of lymph node involvement increased with advancing pathological stage. Mean recurrence-free and bladder cancer specific survival ± SE was 58% ± 2% and 66% ± 2% at 5 years, respectively. On preoperative multivariate analysis clinical tumor stage and neoadjuvant systemic chemotherapy were associated with cancer recurrence, while more advanced age, clinical tumor stage and preoperative carcinoma in situ were associated with bladder cancer specific mortality. On postoperative multivariate analysis pathological tumor stage, lymph node metastasis, lymphovascular invasion, adjuvant radiotherapy and adjuvant chemotherapy were associated with cancer recurrence, while higher pathological tumor stage, more advanced age, lymph node metastasis, lymphovascular invasion and adjuvant radiotherapy were associated with disease specific survival. Patients with metastasis to regional lymph nodes (pT any N1-3) were at significantly higher risk for bladder cancer recurrence and death than patients with extravesical tumor extension (pT3N0), who in turn were at significantly higher risk than patients with organ confined disease (pT2 N0 or less). Conclusions: The results of this large, contemporary, multi-institutional series show that radical cystectomy and pelvic lymphadenectomy provide durable local control and disease specific survival in patients with localized invasive transitional cell carcinoma.
KW - bladder
KW - bladder neoplasms
KW - carcinoma
KW - cystectomy
KW - mortality
KW - transitional cell
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U2 - 10.1016/j.juro.2006.08.004
DO - 10.1016/j.juro.2006.08.004
M3 - Article
C2 - 17085118
AN - SCOPUS:33751057732
SN - 0022-5347
VL - 176
SP - 2414
EP - 2422
JO - Journal of Urology
JF - Journal of Urology
IS - 6
ER -