Partial Cystectomy: A Contemporary Review of the Memorial Sloan-Kettering Cancer Center Experience and Recommendations for Patient Selection

Holzbeierlein, Jeffrey M.; Lopez-Corona, Ernesto; Bochner, Bernard H.; Herr, Harry W.; Donat, S. Machele; Russo, Paul; Dalbagni, Guido; Sogani, Pramod C.

doi:10.1097/01.ju.0000135530.59860.7d

Cited by 149 publications

(126 citation statements)

References 17 publications

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“…Studies have shown that, in carefully selected patients with small, solitary primary tumours at the dome or posterolateral wall of the bladder, PC can be a reasonable alternative to RC because PC allows radical excision of the tumour with comparably less morbidity and preservation of urinary and sexual functions. [3][4][5][6] In our study, the local recurrence rate was 30.7%, comparable with contemporary series reporting local recurrence rates of 19-35%. 3,4 Treatment delays in bladder cancer patients Invasive bladder tumours are aggressive from the time of presentation, suggesting that delaying treatment for such cancer may lead to a worse outcome.…”

Section: Discussionsupporting

confidence: 75%

“…studies have demonstrated that for a highly select patient population, a partial cystectomy (PC) may offer comparable cure rates to RC. 3,4 Ideal candidates for PC are those with favourable disease characteristics such as small, solitary, primary tumours amenable to surgical resection with 2-cm margins, without the need for ureteral reimplantation. 5,6 Even though treatment for invasive bladder cancer should be preferably initiated as soon as the diagnosis has been made, delays in providing such treatment can sometimes be unavoidable owing to factors related to the patient or health care system.…”

Section: Discussionmentioning

confidence: 99%

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Impact of treatment delay in patients with bladder cancer managed with partial cystectomy in Quebec: a population-based study

Fahmy

Aprikian

Alotaibi

et al. 2013

CUAJ

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Objective: Treatment delays have been associated with adverse outcomes in patients with bladder cancer treated with radical cystectomy (RC). We sought to evaluate the impact of treatment delay on disease recurrence and survival in patients with bladder cancer treated with partial cystectomy (PC) in Quebec. Results: A total of 714 patients underwent PC. The median patient age was 70 years. Two-hundred nineteen (30.7%) patients experienced recurrence; of these, 52 (23.7%) required salvage RC. Five-year overall and recurrence-free survival for patients who underwent PC were 49.8% and 40.3%, respectively. Patients delayed more than 12 weeks from transurethral resection of bladder tumours (TURBT) to PC were at significantly increased risk of requiring salvage RC compared with those delayed 12 weeks or less (hazard ratio [HR] 3.0, p < 0.001). Patients who underwent salvage RC had worse survival than patients who had upfront RC (HR 1.5, p = 0.006). Variables including age, sex, presence of hematuria, intravesical therapy, surgeon age, hospital PC volume, surgeon PC volume, type of hospital (academic v. nonacademic) or year of surgery were not significantly associated with PC treatment delay. Methods Conclusion:Treatment delay in patients with bladder cancer managed with PC was associated with increased risk of salvage RC. Patients with bladder cancer who underwent salvage RC had worse outcomes than those who had upfront cystectomy. RésuméObjectif : Chez les patients atteints de cancer de la vessie traités par cystectomie radicale (CR), un délai avant l'instauration du traitement est associé à des résultats défavorables. Nous avons tenté d'évaluer l'impact d'un tel délai sur la récidive de la maladie et le taux de survie des patients atteints de cancer de la vessie traités par cystectomie partielle (CP) au Québec.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Impact of treatment delay in patients with bladder cancer managed with partial cystectomy in Quebec: a population-based study

Fahmy

Aprikian

Alotaibi

et al. 2013

CUAJ

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“…219 The presence of CIS on an initial TURBT or in the partial cystectomy specimen and the presence of lymph node involvement significantly predict tumor recurrence, and patients with these findings should be considered poor candidates for partial cystectomy. 220 …”

Section: Bladder Preservationmentioning

confidence: 99%

Bladder Cancer in 2010: How Far have We Come?

Jacobs¹,

Lee

Montie

2010

CA: A Cancer Journal for Clinicians

300

275

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Bladder cancer is the fourth most common cancer and ranks eighth as a cause of death from cancer among men in the United States. Although guidelines assist in treatment, the art of managing bladder cancer, such as the decision to use neoadjuvant chemotherapy and the timing of cystectomy, is still variable. Bladder cancer has a propensity to recur, and with recurrence, a significant number of cases progress, which makes the early detection of high-risk patients imperative. Advances in detection, surveillance, and treatment of bladder cancer are reviewed in this article.

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“…Parsiyel sistektomi sırasında cerrahi sınırın pozitif olması, CIS varlığı ve çok sayıda tümör olması izlemde nüks olasılığını arttırmaktadır. CIS ve çok odak mevcudiyeti yü-zeyel nükslerle olan ilişkisinin istatistiksel olarak anlamlı olduğu, lenf nodu tutulumu ve cerrahi sınır pozitifliğinin ise ileri nükslerle bağlantılı olduğu saptanmıştır (11). Olgumuzda hem CIS olmayışı, hemde lenf nodu metastazının olmayışı, operasyon öncesi ve sonrası takiplerinde mesane dışı yayılım olmaması gerek nüks, metastaz gerekse sürvi konusunda olumlu parametreler olsada tümörün natürüde göz önüne alındığında sarkomatoid-lenfoepitelyoma diferansiye mesane tümörleri gibi agresif yapıda tü-mörler için parsiyel sistektominin sürvisi konusunda literatürdeki bilgilerde oldukça kısıtlıdır.…”

Section: Discussionunclassified

Sarcomatoid and Lymphoepithelioma Like Differentiated Carcinoma of the Urinary Bladder: Partial Cystectomy a Case Report

Özkan¹,

Balci²,

Hazar³

et al. 2014

JAREM

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ÖZETMesanede en sık rastlanan tümörler ürotelyal karsinomlar olmakla birlikte mesane kanserlerinin %10-20' sinde farklı diferansiyasyon gösteren tümörlerde bulunabilir. Bunlardan biride sarkomatoid ve lenfoepitelyoma benzeri diferansiyasyon gösteren ürotelyal karsinomdur. Daha çok erkeklerde ve ileri yaşta görülür. Tanı anında genelde ileri evredirler. Agresif neoplaziler olup sürvileri kötüdür. Literatürde çeşitli tedavi modaliteleri belirlenmiş olup kesin bir standart yoktur. Bu yazıda ender rastlanan sarkomatoid ve lenfoepitelyoma benzeri diferansiyasyon gösteren ürotelyal mesane karsinomu vakasına uyguladığımız parsiyel sistektominin sonucu literatür eşliğinde tartışılmıştır. (JAREM 2014; 1: 35-7) Anahtar Sözcükler: Mesane, sarkomatoid, ürotelyal karsinom, parsiyel sistektomi ABSTRACT Urothelial carcinomas are the most common tumor types in urinary bladder; however, there may exist different differentiations in 10-20% of bladder cancer, one of which is urothelial carcinoma that has sarcomatoid-and/or lymphoepithelioma-like differentiation. It is usually seen in males in older age and diagnosed during later stages. They are aggressive malignancies and have low survival. Although there are various treatment models determined in the literature, no certain standard is identified. In this study, we report a case of sarcomatoid-and lymphoepithelioma-like differentiated urothelial carcinoma of the urinary bladder that was treated by partial cystectomy and its results in light of the literature. (JAREM 2014; 1: 35-7) Key Words: Urinary bladder, sarcomatoid, urothelial carcinoma, partial cystectomy GİRİŞ Ürolojik kanserler içinde prostat kanserinden sonra ikinci sırada yer alan mesane tümörleri, erkeklerde görülen kanserler içinde dördüncü, kadınlarda ise sekizinci sırada yer almaktadır (1). Mesanede en sık %90-95 oranla ürotelyal hücreli kanser görülür, tanı sırasında yaklaşık %10-20'sinde farklı diferansiyasyon gösteren tü-mörlerde görülebilir (2). Sarkomatoid diferansiyasyon Torenbeek ve ark. (3) 4191 mesane kanserli hastayı inceledikleri çalışmasında %0.31 olarak bildirilmektedir (3). Erkek: Kadın oranı 4:1 olup pik insidans 7. dekattadır (4).Biz, oldukça kötü prognoza sahip sarkomatoid ve lenfoepitelyoma benzeri diferansiyasyon gösteren ürotelyal karsinomun klinik, seyir, teşhis ve tedavi aşamalarıyla farklı bir vaka sunmayı amaç-ladık. OLGU SUNUMUElli altı yaşında erkek hasta pıhtılı makroskopik hematüri şikayet-leri ile kliniğimize başvurdu. Fizik muayenesi, serum biyokimyası ve kan sayımı normaldi. Üriner sistem ultrasonografide (USG) mesane posterior duvarda 50x45x35 mm boyutlarında kitle lezyon tespit edildi ve üst üriner sisteme ait patoloji izlenmedi (Resim 1).Hastaya transüretral rezeksiyon (TUR) planlandı. Sistoskopi önce-si yapılan bimanuel muayenede ele gelen kitle ve fiksasyon yoktu. Mesane arka duvar kubbe bileşkesinde yaklaşık 5 cm çapında papillo-solid tümoral odak izlendi ve rezeksiyon yapıldı (TUR-MT), mesaneden multipl ve prostatik üretradan örnekleme yapıldı. Cerrahi şifa ile eksterne ed...

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Partial Cystectomy: A Contemporary Review of the Memorial Sloan-Kettering Cancer Center Experience and Recommendations for Patient Selection

Abstract: In highly selected patients with invasive bladder cancer, partial cystectomy offers acceptable outcomes. Concomitant CIS and presence of metastases to regional lymph nodes predict advanced recurrence.

Cited by 149 publications

References 17 publications

Impact of treatment delay in patients with bladder cancer managed with partial cystectomy in Quebec: a population-based study

Impact of treatment delay in patients with bladder cancer managed with partial cystectomy in Quebec: a population-based study

Bladder Cancer in 2010: How Far have We Come?

Sarcomatoid and Lymphoepithelioma Like Differentiated Carcinoma of the Urinary Bladder: Partial Cystectomy a Case Report

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