Top

BMC Urology

Published in:

Open Access 01-12-2019 | Cystectomy | Research article

Is hysterectomy beneficial in radical cystectomy for female patient with urothelial carcinoma of bladder? A retrospective analysis of consecutive 112 cases from a single institution

Authors: Haiwen Huang, Bing Yan, Meixia Shang, Libo Liu, Han Hao, Zhijun Xi

Published in: BMC Urology | Issue 1/2019

Abstract

Background

There is no criterion for determining whether female patients operated with cystectomy would benefit from hysterectomy. This study compares the oncological outcomes between female patients receiving uterus preserving cystectomy (UPC) and uterus excision cystectomy (UEC).

Methods

Retrospective review of 121 female patients with urothelial carcinoma of bladder undergoing UPC (n = 63) or UEC (n = 49) at a single institute between January 2006 and April 2017. Individual postoperative follow-up plans were performed for patients through outpatient visits. Overall survival (OS) and progression-free survival (PFS) estimates were analyzed using Kaplan-Meier method and multivariable Cox regression.

Results

The median follow-up time was 36 months (interquartile range 16–69). Among patients, 5 (4.1%) had uterus invasion. OS probability (p = 0.939) and PFS probability (p = 0.565) were similar in two groups. In multivariable Cox regression analysis, hysterectomy was not found to be a predictor of OS (hazard ratio 0.908, 95%CI 0.428–1.924, p = 0.801) and PFS (hazard ratio 1.109, 95%CI 0.439–2.805, p = 0.826) after adjusting for age, preoperative clinical stage, pathological stage, pathological nodal stage, neoadjuvant/adjuvant chemotherapy, location of the tumor, and surgical margin. No significant difference of overall survival probability was observed in the patients with organ-confined bladder cancer (p = 0.675) and in patients with no organ-confined bladder cancer (p = 0.695).

Conclusions

The results showed that the rate of uterus invasion was low in patients analyzed in this cohort. It was also found that hysterectomy was not an independent predictor of OS and PFS after radical cystectomy in patients with bladder cancer.

Available only for authorised users

Antoni S, Ferlay J, Soerjomataram I, Znaor A, Jemal A, Bray F. Bladder Cancer incidence and mortality: a global overview and recent trends. Eur Urol. 2017;71(1):96–108.CrossRef

Dobruch J, Daneshmand S, Fisch M, Lotan Y, Noon AP, Resnick MJ, Shariat SF, Zlotta AR, Boorjian SA. Gender and bladder Cancer: a collaborative review of etiology, biology, and outcomes. Eur Urol. 2016;69(2):300–10.CrossRef

Stenzl A, Nagele U, Kuczyk M, Sievert K-D, Anastasiadis A, Seibold J, Corvin S. Cystectomy – technical considerations in male and female patients. EAU Updat Ser. 2005;3(3):138–46.CrossRef

Weissbart SJ, Smith AL. Hysterectomy in the Urologist’s practice. Curr Urol Rep. 2017;18(1).

Gregg JR, Emeruwa C, Wong J, Barocas DA, Chang SS, Clark PE, Cookson MS, Penson DF, Resnick MJ, Scarpato KR, et al. Oncologic outcomes after anterior Exenteration for muscle invasive bladder Cancer in women. J Urol. 2016;196(4):1030–5.CrossRef

Chang SS, Cole E, Smith JA Jr, Cookson MS. Pathological findings of gynecologic organs obtained at female radical cystectomy. J Urol. 2002;168(1):147–9.CrossRef

Varkarakis IM, Pinggera G, Antoniou N, Constantinides K, Chrisofos M, Deliveliotis C. Pathological review of internal genitalia after anterior exenteration for bladder cancer in women. Evaluating risk factors for female organ involvement. Int Urol Nephrol. 2007;39(4):1015–21.CrossRef

Choi SY, Yoo S, Han JH, Jeong IG, Hong B, Hong JH, Ahn H, Kim C-S, You D. Predictors of female genital organ involvement in radical cystectomy for urothelial carcinoma of the bladder: a single-center retrospective analysis of 112 female patients. Int J Surg. 2017;47:101–6.CrossRef

Salem H, El-Mazny A. Primary and secondary malignant involvement of gynaecological organs at radical cystectomy for bladder cancer: review of literature and retrospective analysis of 360 cases. J Obstet Gynaecol. 2012;32(6):590–3.CrossRef

10.

Ali-El-Dein B, Abdel-Latif M, Mosbah A, Eraky I, Shaaban AA, Taha NM, Ghoneim MA. Secondary malignant involvement of gynecologic organs in radical cystectomy specimens in women: is it mandatory to remove these organs routinely? J Urol. 2004;172(3):885–7.CrossRef

11.

Ali-El-Dein B, Mosbah A, Osman Y, El-Tabey N, Abdel-latif M, Eraky I, Shaaban AA. Preservation of the internal genital organs during radical cystectomy in selected women with bladder cancer: a report on 15 cases with long term follow-up. Eur J Surg Oncol (EJSO). 2013;39(4):358–64.CrossRef

12.

Kluth LA, Rieken M, Xylinas E, Kent M, Rink M, Roupret M, Sharifi N, Jamzadeh A, Kassouf W, Kaushik D, et al. Gender-specific differences in clinicopathologic outcomes following radical cystectomy: an international multi-institutional study of more than 8000 patients. Eur Urol. 2014;66(5):913–9.CrossRef

13.

Tang K, Li H, Xia D, Hu Z, Zhuang Q, Liu J, Xu H, Ye Z. Laparoscopic versus open radical cystectomy in bladder cancer: a systematic review and meta-analysis of comparative studies. PLoS One. 2014;9(5):e95667.CrossRef

14.

Veskimäe E, Neuzillet Y, Rouanne M, MacLennan S, Lam TBL, Yuan Y, Compérat E, Cowan NC, Gakis G, van der Heijden AG, et al. Systematic review of the oncological and functional outcomes of pelvic organ-preserving radical cystectomy (RC) compared with standard RC in women who undergo curative surgery and orthotopic neobladder substitution for bladder cancer. BJU Int. 2017;120(1):12–24.CrossRef

15.

Niver BE, Daneshmand S, Satkunasivam R. Female reproductive organ-sparing radical cystectomy: contemporary indications, techniques and outcomes. Curr Opin Urol. 2015;25(2):105–10.CrossRef

16.

Bhatt A, Nandipati K, Dhar N, Ulchaker J, Jones S, Rackley R, Zippe C. Neurovascular preservation in orthotopic cystectomy: impact on female sexual function. Urology. 2006;67(4):742–5.CrossRef

17.

Puppo P, Introini C, Calvi P, Naselli A. Prevention of chronic urinary retention in orthotopic bladder replacement in the female. Eur Urol. 2005;47(5):674–8 discussion 678.CrossRef

18.

Finley DS, Lee U, McDonough D, Raz S, deKernion J. Urinary retention after orthotopic neobladder substitution in females. J Urol. 2011;186(4):1364–9.CrossRef

Title: Is hysterectomy beneficial in radical cystectomy for female patient with urothelial carcinoma of bladder? A retrospective analysis of consecutive 112 cases from a single institution
Authors: Haiwen Huang
Bing Yan
Meixia Shang
Libo Liu
Han Hao
Zhijun Xi
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Cystectomy
Hysterectomy
Urothelial Cancer
Urothelial Cancer
Cytostatic Therapy
Published in: BMC Urology / Issue 1/2019
Electronic ISSN: 1471-2490
DOI: https://doi.org/10.1186/s12894-019-0461-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Is hysterectomy beneficial in radical cystectomy for female patient with urothelial carcinoma of bladder? A retrospective analysis of consecutive 112 cases from a single institution

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2019

Three novel methods to measure the postoperative displacement of lower urinary tract structures following radical prostatectomy in a sample of Korean patients

Retzius-sparing robot-assisted laparoscopic radical prostatectomy: functional and early oncologic results in aggressive and locally advanced prostate cancer

Epidemic investigation of benign prostatic obstruction with coexisting overactive bladder in Shanghai Pudong New Area and its impact on the health-related quality of life

Prostate-specific antigen (PSA) and distress: - a cross-sectional nationwide survey in men with prostate cancer in Sweden

Patient-reported outcomes in randomised clinical trials of bladder cancer: an updated systematic review

Improving ultrasound-based prostate volume estimation