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01-08-2010 | Original Article

Practice patterns and recurrence after partial cystectomy for bladder cancer

Authors: Nader Fahmy, Armen Aprikian, Simon Tanguay, Salaheddin M. Mahmud, Mohammed Al-Otaibi, Suganthiny Jeyaganth, Moamen Amin, Wassim Kassouf

Published in: World Journal of Urology | Issue 4/2010

Abstract

Purpose

Partial cystectomy (PC) remains a viable alternative to radical cystectomy (RC) for management of invasive bladder cancer in approximately 5% of patients. We used a population-based database to examine practice patterns and recurrence after partial cystectomy.

Materials and methods

We obtained billing records of all partial and radical cystectomies performed for bladder cancer in Quebec from 1983 until 2005. Analysis included age, gender, year of surgery, surgeon’s age, hospital type, preoperative and postoperative visits with accompanying diagnoses and dates of recurrences salvage RC, and death.

Results

A total of 714 (30.4%) patients with invasive bladder cancer underwent PC. Majority of PC (65%) were performed in non-academic institutions. Pelvic lymphadenectomy was performed in only 163 patients (23%) and concomitant ureteral reimplantation was performed in 89 patients (13%). Of 714 patients, 52 (23.7%) required a salvage RC. Median time from PC to salvage RC was 17.6 months (range 1–240 months), respectively. Patients who underwent PC had similar 5-year overall survival compared with patients who underwent upfront RC (49.8% vs. 51%, p = 0.21).

Conclusions

Rate of PC for invasive bladder cancer is significantly higher than expected. Pelvic lymphadenectomy is underutilized in bladder cancer patients treated with PC. Whether prevalent use of PC is due to less stringent selection criteria remains unknown. Since late recurrence is not uncommon, lifelong follow-up is recommended.

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Title: Practice patterns and recurrence after partial cystectomy for bladder cancer
Authors: Nader Fahmy
Armen Aprikian
Simon Tanguay
Salaheddin M. Mahmud
Mohammed Al-Otaibi
Suganthiny Jeyaganth
Moamen Amin
Wassim Kassouf
Publication date: 01-08-2010
Publisher: Springer-Verlag
Published in: World Journal of Urology / Issue 4/2010
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-009-0478-x

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Springer Medicine

Practice patterns and recurrence after partial cystectomy for bladder cancer

Abstract

Purpose

Materials and methods

Results

Conclusions

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Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

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