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Radical Cystectomy for Transitional Cell Carcinoma of the Bladder: What Percentage of Patients Qualifies for Bladder Preservation Protocols?

Radical Cystectomy for Transitional Cell Carcinoma of the Bladder: What Percentage of Patients... The purpose of this study was to determinewhat percentage of patients who underwent radicalcystectomy for transitional cell carcinoma (TCC) of theurinary bladder would also qualify for bladder preservationprotocols with a tri-modality approach. Patients andMethods: A chart review was performed for consecutivepatients (n = 58) who were both diagnosed with TCC andunderwent radical cystectomy at the University of TexasSouthwestern Medical Center. Precystectomy parametersreviewed included tumor depth, focality and resectabilityduring transurethral resection (TUR), as well as radiologicevidence of extravesical disease, hydroureteronephrosisand lymphadenopathy. Final cystectomy pathologicstage was available for all patients. Results: Baseline demographicsincluded: median age 64 years (range 43-88),41 (70.7%) male. Clinical stage: 6 (10.3%) tumor in situ, 6(10.3%) Ta, 23 (39.7%) T1, 20 (34.5 %) T2, and 3 (5.2 %) T4.Based on clinical staging criteria 19 (32.2%) of patientswere deemed appropriate candidates for chemoradiationbladder preservation protocol, while 39 (67.8%) metone or more of the following exclusion criteria: 18 (31.0%)incomplete TUR, 27 (46.6%) multifocal disease, 17 (29.3%) carcinoma in situ (CIS) on random bladder biopsies, 1(1.7%) gross extravesical disease, and 9 (15.6%) presenceof hydroureteronephrosis. Four (21.1%) of 19 candidatesfor bladder preservation were found to have gross extravesicaldisease and/or metastatic lymph node depositson final pathologic staging. Conclusions: While bladderpreservation is feasible for a number of selected patientswith muscle-invasive bladder cancer, only a minority ofpatients that were treated with radical cystectomy qualifiedfor a bladder-sparing approach. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Urology Karger

Radical Cystectomy for Transitional Cell Carcinoma of the Bladder: What Percentage of Patients Qualifies for Bladder Preservation Protocols?

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Publisher
Karger
Copyright
© 2007 S. Karger AG, Basel
ISSN
1661-7649
eISSN
1661-7657
DOI
10.1159/000106524
Publisher site
See Article on Publisher Site

Abstract

The purpose of this study was to determinewhat percentage of patients who underwent radicalcystectomy for transitional cell carcinoma (TCC) of theurinary bladder would also qualify for bladder preservationprotocols with a tri-modality approach. Patients andMethods: A chart review was performed for consecutivepatients (n = 58) who were both diagnosed with TCC andunderwent radical cystectomy at the University of TexasSouthwestern Medical Center. Precystectomy parametersreviewed included tumor depth, focality and resectabilityduring transurethral resection (TUR), as well as radiologicevidence of extravesical disease, hydroureteronephrosisand lymphadenopathy. Final cystectomy pathologicstage was available for all patients. Results: Baseline demographicsincluded: median age 64 years (range 43-88),41 (70.7%) male. Clinical stage: 6 (10.3%) tumor in situ, 6(10.3%) Ta, 23 (39.7%) T1, 20 (34.5 %) T2, and 3 (5.2 %) T4.Based on clinical staging criteria 19 (32.2%) of patientswere deemed appropriate candidates for chemoradiationbladder preservation protocol, while 39 (67.8%) metone or more of the following exclusion criteria: 18 (31.0%)incomplete TUR, 27 (46.6%) multifocal disease, 17 (29.3%) carcinoma in situ (CIS) on random bladder biopsies, 1(1.7%) gross extravesical disease, and 9 (15.6%) presenceof hydroureteronephrosis. Four (21.1%) of 19 candidatesfor bladder preservation were found to have gross extravesicaldisease and/or metastatic lymph node depositson final pathologic staging. Conclusions: While bladderpreservation is feasible for a number of selected patientswith muscle-invasive bladder cancer, only a minority ofpatients that were treated with radical cystectomy qualifiedfor a bladder-sparing approach.

Journal

Current UrologyKarger

Published: Jan 1, 2007

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