Outcomes of radical cystectomy and bladder preservation treatment for muscle-invasive urothelial carcinoma of the bladder

Supit, Wempy; Mochtar, Chaidir Arif; Santoso, Rachmat Budi; Umbas, Rainy

doi:10.1016/j.asjsur.2014.01.010

Cited by 8 publications

(15 citation statements)

References 24 publications

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“…RC has long been recommended as the ‘gold standard’ treatment for patients with MIBC, as well as being indicated for high-risk and recurrent NMIBC [1] , [17] . Published series report favourable survival outcomes after RC for MIBC when compared to bladder preservation treatments such as radical radiotherapy, transurethral resection of bladder tumours, and local chemotherapy [17] , [18] , [19] . Patients being managed conservatively could potentially lead to multiple hospital admissions with complications of bladder cancer such as haematuria, leading to significant anaemia, and bladder dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Radical cystectomy in the elderly – Is this a safe treatment option?

Young

Elmussareh

Weston

et al. 2017

Arab Journal of Urology

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ObjectiveTo determine if significant differences exist in the perioperative outcomes of patients aged >75 years treated with radical cystectomy (RC) compared to younger patients, as RC is frequently not offered to ‘elderly’ patients with bladder cancer because of supposed increased risks of complications.Patients and methodsWe retrospectively analysed prospectively collected data of all patients that underwent RC in our centre from May 2013 to June 2015. In all, 81 consecutive RCs were identified and included in our study. Patients were divided into two age groups: Group A, aged <75 years (51 patients) and Group B, aged ≥75 years (30). Co-morbidities and perioperative outcomes were compared between the groups. Fisher’s exact test was used for statistical analysis.ResultsIn 68 patients RC was performed laparoscopically and the remaining 13 patients underwent open RC. The mean (range) age was 70.7 (36–85) years. There were 37 patients with muscle-invasive disease and 42 had non-muscle-invasive disease. The median hospital stay was not significantly different between the two age groups (10 vs 11 days). There was no significant difference in the preoperative Charlson co-morbidity index. The 30-day mortality rate was 4% for those aged <75 years and 6.6% for those aged ≥75 years, with overall perioperative complication rates of 57% vs 66%, respectively. Most complications were minor (Clavien–Dindo Grade I–II) and there was no statistically significant difference between the two cohorts. There was also no statistically significant difference in blood transfusion rates.ConclusionRC in patients aged ≥75 years has similar perioperative morbidity when compared with younger patients and can be offered in selected elderly patients. Thus, age should not be an absolute contraindication for RC.

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Section: Discussionmentioning

confidence: 99%

Radical cystectomy in the elderly – Is this a safe treatment option?

Young

Elmussareh

Weston

et al. 2017

Arab Journal of Urology

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“…Among these patients, 13.3 and 26.7% underwent radical cystectomy (RC) and radiotherapy, respectively; the other 60% had TURBT only without further definitive treatment (15). The 5-year OS was 50, 22.7 and 8.3% for RC, radiotherapy and TURBT only, respectively.…”

Section: Bladder Cancermentioning

confidence: 97%

Urologic cancer in Indonesia

Umbas

Safriadi

Mochtar

et al. 2015

Jpn. J. Clin. Oncol.

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Non-communicable diseases, including cancer, start to become more common in Indonesia. According to the government statement, incidence of malignant diseases increased annually up to 8% in the last decade and these diseases become the seventh leading cause of death in Indonesia. On the basis of the latest Globocan report on cancer incidence in Indonesia, prostate cancer ranks sixth; followed by bladder (12th) and kidney (18th). More than half of patients with kidney cancer are diagnosed in the advanced stage. Besides renal cell carcinoma, there are significant number of people affected with squamous cell and transitional cell carcinoma because of kidney stones. Radical nephrectomy or cytoreductive nephrectomy was the primary treatment, mostly done as an open procedure. Transitional cell carcinoma is the commonest histology type in bladder cancer cases followed by squamous cell carcinoma, which almost always related to bladder stones. Unfortunately, >70% of our cases were diagnosed with muscle invasive bladder cancer, and ∼60% of these patients refused further radical treatment. Incidence of prostate cancer is increasing rapidly and it becomes the third most common cancer in men. However, most of our patients are diagnosed in the advanced stage. Radical prostatectomy or external beam radiotherapy is the treatment of choice in localized disease. Nearly 40% of the elderly patients are treated with primary androgen deprivation therapy. Therefore, it requires more research by the Indonesian urologists and other healthcare providers to diagnose these cancers in earlier stage as well as community education for prevention.

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“…24 For T2 disease, the 5-year OS was 62.5% for RC, 31.2% for radiotherapy and 8.3% for TURBT (log-rank P = 0.017). 24 Given these, most of the researchers gave up applying monotherapy aiming at bladder preservation. Similarly, systemic chemotherapy as monotherapy is inadequate and cannot be recommended.…”

Section: Modality Of Preservation Solo Preservation Therapy In Comparmentioning

confidence: 93%

“…followed 150 patients with T2–T4a, N0, M0 UBC treated with RC, TURBT or radiotherapy . The actual 5‐year OS for all patients was 50% for RC, 22.7% for radiotherapy and just 8.3% for TURBT, suggesting RC is the only reliable single therapy among all (log–rank P = 0.029) . For T2 disease, the 5‐year OS was 62.5% for RC, 31.2% for radiotherapy and 8.3% for TURBT (log–rank P = 0.017) .…”

Section: Modality Of Preservationmentioning

confidence: 99%

“…The actual 5‐year OS for all patients was 50% for RC, 22.7% for radiotherapy and just 8.3% for TURBT, suggesting RC is the only reliable single therapy among all (log–rank P = 0.029) . For T2 disease, the 5‐year OS was 62.5% for RC, 31.2% for radiotherapy and 8.3% for TURBT (log–rank P = 0.017) . Given these, most of the researchers gave up applying monotherapy aiming at bladder preservation.…”

Section: Modality Of Preservationmentioning

confidence: 99%

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Can bladder preservation therapy come to the center stage?

et al. 2017

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Decision-making in urological cancer care requires a multidisciplinary approach for refinement, but its impact on urothelial carcinoma of the bladder has not been fully addressed for the past three decades, except for the latest immunological checkpoint inhibitor approved by the U.S. Food and Drug Administration for metastatic muscle-invasive bladder cancer that is resistant to platinum-based chemotherapy. For the time being, radical cystectomy is the gold standard of curative therapy for muscleinvasive bladder cancer. Trimodal therapy that combines chemotherapy for the purpose of radiation sensitization, external beam radiotherapy and transurethral resection of bladder tumor has emerged as a potential alternative treatment option that preserves the bladder. In lack of randomized studies for bladder preservation therapy compared with surgery, the principles of management of urothelial carcinoma of the bladder have evolved in recent times, with an emphasis on bladder preservation. A number of bladder preservation techniques are available to the surgeon; however, appropriately selected patients with muscle-invasive bladder cancer should be offered the opportunity to discuss various treatment options, including organ-sparing trimodal therapy. The aim of the present study was to compare the primary outcomes of the available treatment methods and identify the sources of variance among studies. A review of various bladder preservation techniques in vogue for the management of urothelial carcinoma of the bladder is discussed.

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Outcomes of radical cystectomy and bladder preservation treatment for muscle-invasive urothelial carcinoma of the bladder

Cited by 8 publications

References 24 publications

Radical cystectomy in the elderly – Is this a safe treatment option?

Radical cystectomy in the elderly – Is this a safe treatment option?

Urologic cancer in Indonesia

Can bladder preservation therapy come to the center stage?

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