Radical cystectomy and urinary diversion outcomes in patients with single vs. double renal unit: A 2:1 matched-pair analysis

Mora, Richard Mateo; Ghoreifi, Alireza; Ladi‐Seyedian, Seyedeh‐Sanam; Moghaddam, Farshad Sheybaee; Cai, Jie; Miranda, Gus; Aron, Monish; Schuckman, Anne; Desai, Mihir; Gill, Inderbir S.; Daneshmand, Siamak; Djaladat, Hooman

doi:10.1016/j.urolonc.2022.12.004

Cited by 1 publication

(2 citation statements)

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“…Although the median follow-up period was relatively short in our study, in line with a previous study [22], our findings demonstrate a significant decrease in renal function in the RC group compared to the BPT and RT group after treatment. This decline in renal function following RC is concerning, particularly for patients with a single functioning kidney, as they are more susceptible to renal function deterioration than patients with 2 functioning kidneys [3]. The decline in renal function following RC may increase the risk of chronic kidney disease and have a negative impact on long-term OS.…”

Section: Discussionmentioning

confidence: 99%

“…Radical cystectomy (RC) is still considered the standard treatment for patients with nonmetastatic muscle-invasive bladder cancer (MIBC). However, RC is associated with significant morbidity and diminished quality of life [1][2][3]. In recent years, several international guidelines have recognized bladder-preserving therapy (BPT) with maximal transurethral resection of bladder tumor (TURBT) and concurrent chemoradiotherapy as an alternative to RC for selected patients.…”

Section: Introductionmentioning

confidence: 99%

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Radical Cystectomy Versus Bladder-Preserving Therapy in Muscle-Invasive Bladder Cancer Patients After Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Multicenter Retrospective Analysis

Jo¹,

Kim²,

Shin³

et al. 2023

J Urol Oncol

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Purpose: Although radical cystectomy (RC) and concurrent chemoradiotherapy (CCRT) are curative options for muscle-invasive bladder cancer (MIBC), the optimal treatment strategy for MIBC patients with a history of nephroureterectomy for upper tract urothelial carcinoma (UTUC) remains unclear. This retrospective analysis was conducted to compare survival rates and evaluate prognostic factors related to treatment outcomes.Materials and Methods: We conducted a multi-institutional retrospective study of patients with MIBC after nephroureterectomy for UTUC between 2005 to 2023. Out of 75 patients, 30 underwent bladder-preserving therapy (BPT), including 22 patients who underwent radiation therapy (RT) and 8 patients who underwent CCRT, while 45 patients underwent RC. The overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) after BPT and RC were evaluated using Kaplan-Meier curves. Cox regression analysis was used to identify variables associated with OS, CSS, and PFS. Posttreatment changes in renal function were compared.Results: At 3 years, the OS, CSS, and PFS rates in the BPT group were 52.4%, 71.7%, and 31.3%, respectively, with no significant difference compared to RC. In multivariate analysis, bladder cancer T stage was the only predictive factor for OS, CSS, and PFS. Similar results were also observed in the RT group compared to RC. A significant decrease in renal function was detected among patients in the RC group, while patients in the BPT group maintained preserved renal function. Patients in the BPT group experienced a lower grade of toxicity after treatment compared to those in the RC group, and the rates of survival with functional bladder at 1 year, 3 years, and 5 years were 87.0%, 69.9%, and 69.9%, respectively.Conclusions: Bladder-preserving therapy, including RT alone, may be a viable treatment option for patients with MIBC who have undergone nephroureterectomy, as it can achieve comparable oncologic outcomes to RC, while potentially preserving bladder and renal function.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%