Outcomes of radical cystectomy

Thalmann, George N.; Stein, John P.

doi:10.1111/j.1464-410x.2008.07971.x

Cited by 22 publications

(17 citation statements)

References 98 publications

(158 reference statements)

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Section: Introductionmentioning

confidence: 99%

“…At the time of diagnosis, 20% of patients present with muscle-invasive tumors, and without treatment > 85% of patients with invasive disease succumb to their disease within 2 years after diagnosis [49]. The standard therapy for patients with muscle-invasive cancer in most institutions is still radical cystectomy and pelvic lymphadenectomy providing 5-year overall survival rates of 60% [47,49].New surgical techniques emerged rapidly during the last years with the development of continent orthotopic urinary diversion and nerve-sparing techniques to improve both functional results and quality of life [3,4,18], but even the construction of a neobladder cannot substitute for the original urinary bladder.Bladder-preserving strategies such as radiotherapy and radiochemotherapy combined with a transurethral resection of the bladder tumor (TURBT) have been shown to offer an attractive alternative to radical cystectomy providing complete response rates of 60-85%, 5-year survival rates of 50-60%, and survival rates with an intact bladder of 40-45% [24,25,34,35,40,51]. Although there are no randomized trials comparing radical cystectomy with bladder-preserving therapy, long-term data show that overall and disease-specific survival rates in radical cystectomy series of patients with T2-T4a tumors are comparable to those achieved by bladder-preserving strategies [7,14,27,28].…”

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Treatment Results of Radiation Therapy for Muscle-Invasive Bladder Cancer

et al. 2010

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Treatment Results of Radiation Therapy for Muscle-Invasive Bladder Cancer

et al. 2010

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“…[3] There could be many reasons for this. Non standardization of the technique of cystectomy and regional lymph node clearance, no universal agreement on perioperative chemotherapy, lack of further progress in new drug development and lack of knowledge of the biological behavior of bladder cancer could well be the reasons behind a poor outcome.…”

Section: Discussionmentioning

confidence: 99%

“…Despite advances in surgical techniques and chemotherapy the 10-year disease-free survival of muscle-invasive disease in many large series is 50-60%. [3] Most deaths due to bladder cancer are directly related to the higher stage of the disease i.e., T2 or higher and higher grade. [4] At initial diagnosis almost 50% of the patients with high-grade bladder cancer have muscle invasive disease, of these 50% have distant metastasis with in 2 years and almost 50-60% of these patients die with 5 years despite treatment.…”

Section: Introductionmentioning

confidence: 99%

Rationale for an early detection program for bladder cancer

Khochikar

2011

Indian J Urol

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Introduction:A total of 356,557 new cases were diagnosed annually worldwide in 2009, it was estimated that 52,810 new patients were to be diagnosed with bladder cancer and there were 10,180 projected deaths from the disease in the USA. Despite being the fourth commonest cancer in men, we do not have an early detection/screening program for bladder cancer. The review was aimed at looking at the evidence for the rationale for an early detection program for bladder cancer.Materials and Methods:A detailed search on bladder cancer epidemiology, diagnosis, pathology, tumor markers, treatment outcomes, screening, morbidity and mortality of bladder cancer was carried out on Pubmed central/Medline. Original articles, review articles, monograms, book chapters on bladder cancer, text books on urological oncology, oncology and urology were reviewed. The latest information for new articles before publication was last accessed in June 2010.Discussion and Conclusions:Bladder cancer is the fourth commonest cancer in men, the annual death rate from this disease is significant and every year there is an increase in its incidence globally. The prognosis of bladder cancer is stage and grade dependent; the lower the stage (T2 or less) the better is the survival. Delay in the diagnosis and treatment does alter the overall outcome. Therefore, there is a clear need for early detection of bladder cancer and screening program. Although we do not have an ideal marker for bladder cancer, it is time we maximize the potential of markers such as UroVysion, NMP22 along with cytology to start such a program. May be as a first step the early detection and screening program could be started in high-risk population. It is not worth waiting till we find the best marker as it would be unfair to our patients. The fear of unnecessary tests and treatment in bladder cancer after its detection in screening program is without any substance. The cost-effectiveness of such a program is certainly comparable to that is used for colon or breast and for prostate as well.

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“…Radical cystectomy is the standard treatment for recurrent high-risk superficial or invasive bladder cancer because it provides excellent local cancer control [1] . Since the first LRC for muscle invasive bladder cancer was reported by Sánchez de Badajoz et al [4] in 1995, LRC has become a standard procedure at many laparoscopic centers worldwide.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Hand-Assisted Laparoscopic and Open Radical Cystectomy for Bladder Cancer

Wang

Chen²,

Wang³

et al. 2010

Urol Int

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Purpose: To present our experience of hand-assisted laparoscopic radical cystectomy (HALRC) and compare it with open radical cystectomy (ORC). Patients and Methods: During the period between May 2004 and November 2007, 31 patients underwent HALRC and 39 patients underwent ORC for bladder cancer. The patient demographics, intraoperative variables and postoperative outcomes were compared retrospectively. Results: There was no statistically significant difference with regard to age, sex, body mass index, and urinary diversion in the 2 groups. In the HALRC group, 20 patients had stage pT2 or less, 7 had pT3 disease, and 4 had stage pT4 disease. In the ORC group, 29 patients had stage pT2 or less, 5 had pT3 disease, and 5 had stage pT4 disease. All margins in both groups were negative. The HALRC group had decreased blood loss (250.9 vs. 812.8 ml, p < 0.001) and a lower rate of transfusion (9.7 vs. 76.9%, p < 0.001), but similar mean operative time (365.7 vs. 362.6 min, p = 0.862). Time to liquid diet was significantly less in the HALRC group versus the ORC group (4.3 vs. 6.3 days, p < 0.001). The median number of lymph nodes were similar between the HALRC and ORC groups (14 vs. 15, p = 0.377). Six patients developed perioperative complications in the HALRC group and 12 patients had complications in the ORC group (19.4 vs. 30.8%, p = 0.278). Late complications occurred in 3 patients (2 parastomal hernias and 1 ureteroenteral stricture) in the HALRC group. Conclusions: Compared with ORC, HALRC patients had decreased blood loss, less transfusion requirements, and quicker intestinal recovery. Long-term follow-up in a larger cohort of patients is needed to assess the long-term oncological and functional outcomes.

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Outcomes of radical cystectomy

Cited by 22 publications

References 98 publications

Treatment Results of Radiation Therapy for Muscle-Invasive Bladder Cancer

Treatment Results of Radiation Therapy for Muscle-Invasive Bladder Cancer

Rationale for an early detection program for bladder cancer

Comparison of Hand-Assisted Laparoscopic and Open Radical Cystectomy for Bladder Cancer

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