Oncological outcomes, quality of life outcomes and complications of partial cystectomy for selected cases of muscle-invasive bladder cancer

Abstract

To evaluate the oncological results, associated complications, and postoperative health-related quality of life (HR-QoL) in patients treated with partial cystectomy (PC) for muscle-invasive bladder cancer (MIBC). 27 patients who underwent open PC for cT2 MIBC were included. A simple Cox’s proportional hazards regression model was used to assess the association of several potential prognostic factors with survival. Postoperative HR-QoL was assessed with the EORTC (European Organisation for the Research and Treatment of Cancer) QLQ-C30 questionnaire version 3.0. Final pathological tumour stages in PC specimen were: pT0: 18.5%, non-MIBC: 3.7%, MIBC: 74.1%, pCIS: 14.8%. Estimated 5-year overall- and progression-free survival rates were 53.7% and 62.1%. Five (18.5%) patients experienced local recurrence with MIBC. Overall, the salvage cystectomy rate was 18.5%. The 90-day mortality rate was 0%. Significant risk factors for progression-free survival were vascular invasion (HR 5.33) and tumour multilocularity (HR 4.5) in the PC specimen, and a ureteric reimplantation during PC (HR 4.53). The rates of intraoperative complications, 30- and 90-day major complications were 7.4%, respectively and 14.8% for overall long-term complications. Postoperatively, median (IQR) global health status and QoL in our PC cohort was 79.2 (52.1–97.9). Open PC can provide adequate cancer control of MIBC with good HR-QoL in highly selected cases. Open PC can lead to long-term bladder preservation and shows an acceptable rate of severe perioperative complications, even in highly comorbid patients.

Korean version of the convalescence and recovery evaluation: translation and linguistic validation

“…Over the past few decades, interest in QoL has increased, especially because of the developments of new surgical techniques and equipment. 9 This increase in interest has led to the devising of a variety of tools for assessing patient QoL after surgery, 10 especially new questionnaires. 11 However, the topics covered by the questionnaires have differed, and most of them have focused on the long-term postoperative outcomes.…”

Bladder preservation in muscle-invasive bladder cancer: a comprehensive review

“…Latter PC series with more defined patient selection criteria revealed promising outcomes comparable to RC, although most series had small sample sizes. Across these series, 5-year OS ranged from 53.7% to 70%, and locally advanced tumor recurrence rates ranged from 18.5% to 38% ( Table-3) (62,63,70,71).…”

“…With this procedure, as compared to maximal TUR, a surgeon has the ability to more completely assess surgical margins as well as perform PLND if indicated. Factors associated with poor oncologic outcomes following PC include presence of positive pelvic lymph nodes, lymphovascular invasion, need for ureteral reimplantation, and urothelial histology ( 61 - 63 ).…”

“… N = 58 Mean: 33 mo 5-year OS = 69%; Superficial recurrence = 12%; Advanced recurrence = 38% Concomitant CIS and lymph node involvement predictors of advanced recurrence. Ebbing et al 2018 ( 63 ) Retrospective, single institution cT2 only; Medically unfit for RC or elected BPT N = 27 Median: 36.5 mo 5-year OS = 53.7%; Local recurrence = 18.5%; Salvage cystectomy = 18.5% Less stringent selection criteria showed worse but comparable outcomes. Smaldone et al 2008 ( 70 ) Retrospective, single institution solitary primary T2 (68%) or T1HG (32%) N = 25 Mean: 45.3 mo 5-yr recurrence-free, DSS, and OS = 64%, 84%, and 74%, respectively.…”

Obatoclax, a BH3 Mimetic, Enhances Cisplatin-Induced Apoptosis and Decreases the Clonogenicity of Muscle Invasive Bladder Cancer Cells via Mechanisms That Involve the Inhibition of Pro-Survival Molecules as Well as Cell Cycle Regulators

“…The current 5-year survival rate for patients with muscle invasive bladder cancer (MI-BC) is estimated to be approximately 50% [1]. Several clinical studies support neoadjuvant chemotherapy (NAC), primarily in the form of platinum-based DNA damaging agents such as cisplatin, as being the standard of care therapy for MI-BC patients [2,3].…”