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01-10-2014 | Original Article

Impact of concomitant carcinoma in situ on upstaging and outcome following radical cystectomy for bladder cancer

Authors: Faysal A. Yafi, Armen G. Aprikian, Joseph L. Chin, Yves Fradet, Jonathan Izawa, Eric Estey, Adrian Fairey, Ricardo Rendon, Ilias Cagiannos, Louis Lacombe, Jean-Baptiste Lattouf, Fred Saad, David Bell, Darrel Drachenberg, Wassim Kassouf

Published in: World Journal of Urology | Issue 5/2014

Abstract

Purpose

To evaluate the impact of concomitant carcinoma in situ (CIS) on upstaging and outcome of patients treated with radical cystectomy with pelvic lymph node dissection.

Methods

We collected and pooled a database of 1,968 patients who have undergone radical cystectomy between 1998 and 2008 in eight academic centers across Canada. Collected variables included patient’s age, gender, tumor grade, histology and the presence of concomitant CIS with either cTa-1 or cT2 disease, dates of recurrence and death.

Results

In the presence of concomitant CIS, upstaging following radical cystectomy occurred in 48 and 55 % of patients with cTa-1 and cT2 disease, respectively. On univariate analysis, the presence of concomitant CIS with cT2 disease was associated with upstaging (p < 0.0001), and the presence of concomitant CIS with cTa-1 disease was also associated with upstaging but did not reach statistical significance (p = 0.0526). On multivariate analyses, the presence of concomitant CIS with either cTa-1 or cT2 tumors was independently prognostic of disease upstaging (p = 0.0001 and 0.0186, respectively). However, on multivariate analysis that incorporates pathologic stage, concomitant CIS was not significantly associated with worse overall, recurrence-free or disease-specific survival.

Conclusion

These results demonstrate that while the presence of concomitant CIS on cystectomy specimens does not independently affect outcomes, its presence is significantly predictive of a higher rate of upstaging at radical cystectomy.

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Title: Impact of concomitant carcinoma in situ on upstaging and outcome following radical cystectomy for bladder cancer
Authors: Faysal A. Yafi
Armen G. Aprikian
Joseph L. Chin
Yves Fradet
Jonathan Izawa
Eric Estey
Adrian Fairey
Ricardo Rendon
Ilias Cagiannos
Louis Lacombe
Jean-Baptiste Lattouf
Fred Saad
David Bell
Darrel Drachenberg
Wassim Kassouf
Publication date: 01-10-2014
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 5/2014
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-013-1207-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of concomitant carcinoma in situ on upstaging and outcome following radical cystectomy for bladder cancer

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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