Local recurrences after radical cystectomy in bladder cancer patients
- 作者: Komyakov B.1,2, Saad A.1, Fadeev V.1,2, Al-Attar T.1,2, Sergeev A.1,2
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隶属关系:
- North-Western State Medical University named after I.I. Mechnikov
- Multidisciplinary City Hospital No. 2
- 期: 卷 12, 编号 4 (2022)
- 页面: 269-276
- 栏目: Original articles
- URL: https://journals.rcsi.science/uroved/article/view/134229
- DOI: https://doi.org/10.17816/uroved112087
- ID: 134229
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详细
BACKGROUND: Radical cystectomy is the standard treatment for patients with muscle-invasive bladder cancer and superficial neoplasms in cases of resistance to intravesical immunochemotherapy.
AIM: To establish the frequency of local pelvic recurrence in patients with bladder cancer after radical cystectomy.
MATERIALS AND METHODS: From 1997 to 2022 radical cystectomy was performed in 407 patients with bladder cancer: 344 (84.5%) men and 63 (15.5%) women. Orthotopic urinary diversion methods were performed in 302 (74.2%) patients, including gastrocystoplasty — 24 (5.9%), ileocystoplasty — 253 (63.8%) and sigmocystoplasty — 25 (6.1%) patients. Continent skin diversion of urine was performed in 13 (3.2%) patients, ureter transplantation into the sigmoid colon — in 42 (10.3%) patients, and ureterocutaneostomy — in 50 (12.3%) patients.
RESULTS: Local recurrence in the pelvis after radical cystectomy was observed in 33 (8.1%) patients: 27 (81.8%) men and 6 (18.2%) women. The average age of men with relapses was 58.7 ± 11.7 years (from 43 to 73 years), women — 50.0 ± 7.8 years (from 24 to 65 years). Simultaneous metastatic lesions of internal organs were detected in 6 (18.2%) patients. Local pelvic recurrence after radical cystectomy occurred more often in lymphopositive patients with extravesical spread of the primary low-grade tumor. The median time from radical cystectomy to detection of pelvic recurrence was 7.0 months, from the moment of detection of pelvic recurrence to the death of the patient — 4.5 months.
CONCLUSIONS: The frequency of local pelvic recurrence of bladder cancer after radical cystectomy is 8.1%. The survival rate of patients with local pelvic recurrence is extremely low.
作者简介
Boris Komyakov
North-Western State Medical University named after I.I. Mechnikov; Multidisciplinary City Hospital No. 2
Email: komyakovbk@mail.ru
ORCID iD: 0000-0002-8606-9791
SPIN 代码: 7864-9123
Dr. Sci. (Med.), Professor; Head of the Department of Urology; Head of the Urological Unit
俄罗斯联邦, Saint Petersburg; Saint PetersburgAnton Saad
North-Western State Medical University named after I.I. Mechnikov
Email: dr.a.e.saad@gmail.com
Postgraduate Student of the Department of Urology
俄罗斯联邦, Saint PetersburgVladimir Fadeev
North-Western State Medical University named after I.I. Mechnikov; Multidisciplinary City Hospital No. 2
Email: fad_ur_75@mail.ru
SPIN 代码: 6731-2605
Dr. Sci. (Med.); Professor of the Department of Urology; Urologist, Urological Unit
俄罗斯联邦, Saint Petersburg; Saint PetersburgTalat Al-Attar
North-Western State Medical University named after I.I. Mechnikov; Multidisciplinary City Hospital No. 2
Email: dr-talat@mail.ru
ORCID iD: 0000-0002-2080-5637
SPIN 代码: 9550-7507
Dr. Sci. (Med.); Professor of the Department of Urology; Urologist, Urological Unit
俄罗斯联邦, Saint Petersburg; Saint PetersburgAleksey Sergeev
North-Western State Medical University named after I.I. Mechnikov; Multidisciplinary City Hospital No. 2
编辑信件的主要联系方式.
Email: urolsergeev@gmail.com
ORCID iD: 0000-0002-0324-4911
SPIN 代码: 3108-4781
Dr. Sci. (Med.); Professor of the Department of Urology; Urologist, Urological Unit
俄罗斯联邦, Saint Petersburg; Saint Petersburg参考
- Komyakov BK, Sergeev AV, Fadeev VA. Limfodissektsiya pri radikalnoi tsistehktomii. Problems in oncology. 2010;56(5):508–513. (In Russ.)
- Komyakov BK, Fadeev VA, Sergeev AV. Cystectomy and bladder substitution in women. Journal of obstetrics and women’s diseases. 2011;60(2):48–50. (In Russ.)
- Komyakov BK, Guliev BG, Sergeev AV, et al. Survival of patients with bladder cancer after radical cystectomy. Cancer Urology. 2016;12(1): 29–35. (In Russ.) doi: 10.17650/1726-9776-2016-12-1-29-35
- Krasnyi SS, Sukonko OG, Rolevich AI. Results of treatment in patients with urinary bladder cancer metastasizing to regional lymph nodes. Cancer Urology. 2007;3(3):35–41. (In Russ.) doi: 10.17650/1726-9776-2007-3-3-35-41
- Krasny SA, Sukonko OG, Polyakov SL, et al. Predictors of early severe complications after radical cystectomy. Cancer Urology. 2010;6(4):42–46. (In Russ.) doi: 10.17650/1726-9776-2010-6-4-42-46
- Hautmann RE, de Petriconi RC, Volkmer BG. Lessons learned from 1,000 neobladders: the 90-day complication rate. J Urol. 2010;184(3):990–994. doi: 10.1016/j.juro.2010.05.037
- Hautmann RE, de Petriconi RC, Volkmer BG. 25 years of experience with 1,000 neobladders: long-term complications. J Urol. 2011;185(6):2207–2212. doi: 10.1016/j.juro.2011.02.006
- Khanna A, Miest T, Sharma V, et al. Role of lymphadenectomy during radical cystectomy for nonmuscle-invasive bladder cancer: results from a multi-institutional experience. J Urol. 2022;207(3): 551–558. doi: 10.1097/JU.0000000000002266
- Zaghloul MS, Christodouleas JP, Smith A, et al. Adjuvant sandwich chemotherapy plus radiotherapy vs adjuvant chemotherapy alone for locally advanced bladder cancer after radical cystectomy: a randomized phase 2 trial. JAMA Surg. 2018;153(1):e174591. doi: 10.1001/jamasurg.2017.4591
- Kim HJ, Chun J, Kim TH, et al. Patterns of locoregional recurrence after radical cystectomy for stage t3–4 bladder cancer: a radiation oncologist’s point of view. Yonsei Med J. 2021;62(7):569–576. doi: 10.3349/ymj.2021.62.7.569
- Baumann BC, Zaghloul MS, Sargos P, Murthy V. Adjuvant and neoadjuvant radiation therapy for locally advanced bladder cancer. Clin Oncol (R Coll Radiol). 2021;33(6):391–399. doi: 10.1016/j.clon.2021.03.020
- Takeuchi S, Nakane K, Saigo C, et al. A Case of muscle-invasive bladder cancer with pelvic lymph node involvement treated with pembrolizumab and subsequent radical cystectomy and maintained no evidence of disease after surgery. Cureus. 2021;13(11):e19375. doi: 10.7759/cureus.19375
- Zennami K, Sumitomo M, Takahara K, et al. Intra-corporeal robot-assisted versus open radical cystectomy: a propensity score-matched analysis comparing perioperative and long-term survival outcomes and recurrence patterns. Int J Clin Oncol. 2021;26(8): 1514–1523. doi: 10.1007/s10147-021-01939-3
- Zhu G, Zhang Z, Zhao K, et al. Laparoscopic radical cystectomy with pelvic lymph node dissection and ileal orthotopic neobladder by a total extraperitoneal approach: Our initial technique and short-term outcomes. Investig Clin Urol. 2022;63(5):523–530. doi: 10.4111/icu.20220156
- Kessler TM, Burkhard FC, Perimenis P, et al Attempted nerve sparing surgery and age have a significant effect on urinary continence and erectile function after radical cystoprostatectomy and ileal orthotopic bladder substitution. J Urol. 2004;172(4–1):1323–1327. doi: 10.1097/01.ju.0000138249.31644.ec
- Mannion L, Bosco C, Nair R, et al. Overall survival, disease-specific survival and local recurrence outcomes in patients with muscle-invasive bladder cancer treated with external beam radiotherapy and brachytherapy: a systematic review. BJU Int. 2020;125(6):780–791. doi: 10.1111/bju.15047
- Moschovas MC, Seetharam Bhat KR, Jenson C, et al. Robtic-assisted radical cystectomy: Literature review. Asian J Urol. 2021;8(1):14–19. doi: 10.1016/j.ajur.2020.06.007
- Wei L, Hussein AA, Ma Y, et al. Accurate Quantification of residual cancer cells in pelvic washing reveals association with cancer recurrence following robot-assisted radical cystectomy. J Urol. 2019;201(6):1105–1114. doi: 10.1097/JU.0000000000000142
- Elsayed AS, Iqbal U, Jing Z, et al. Relapses rates and patterns for pathological t0 after robot-assisted radical cystectomy: results from the international robotic cystectomy consortium. Urology. 2022;166:177–181. doi: 10.1016/j.urology.2022.03.035
- Holmberg L, Hagberg O, Häggström C, et al. Number of transurethral procedures after non-muscle-invasive bladder cancer and survival in causes other than bladder cancer. PLoS One. 2022;17(9): e0274859. doi: 10.1371/journal.pone.0274859
- Mehrnoush V, Brennan L, Ismail A, et al. Radical cystectomy for bladder urothelial carcinoma with aggressive variant histology. Arch Ital Urol Androl. 2022;94(3):291–294. doi: 10.4081/aiua.2022.3.291
- Heck MM, Koll FJ, Retz M, et al. Molecular lymph node staging for bladder cancer patients undergoing radical cystectomy with pelvic lymph node dissection. Urol Oncol. 2020;38(7):639.e11–639.e19. doi: 10.1016/j.urolonc.2020.01.018
- Pieretti A, Krasnow R, Drumm M, et al. Complications and outcomes of salvage cystectomy after trimodality therapy. J Urol. 2021;206(1):29–36. doi: 10.1097/JU.0000000000001696
- Moschini M, Zamboni S, Mattei A, et al. Radical cystectomy in pathological t4a and t4b bladder cancer patients: is there any space for sub stratification? Urol Int. 2019;102(3):269–276. doi: 10.1159/000493899
- Bree KK, Hensley PJ, Westerman ME, et al. Contemporary rates of gynecologic organ involvement in females with muscle invasive bladder cancer: a retrospective review of women undergoing radical cystectomy following neoadjuvant chemotherapy. J Urol. 2021;206(3):577–585. doi: 10.1097/JU.000000000000178
- König F, Pradere B, Grossmann NC, et al. Quality indicators for the management of muscle-invasive bladder cancer in the perioperative setting of radical cystectomy: a narrative review. Transl Cancer Res. 2022;11(4):908–917. doi: 10.21037/tcr-21–1116
- Ozbir S, Girgin C, Kara C, Dinçel C. Local and systemic recurrence patterns of urothelial cancer after radical cystectomy. Kaohsiung J Med Sci. 2014;30(10):504–509. doi: 10.1016/j.kjms.2014.03.011
- Murthy V, Bakshi G, Manjali JJ, et al. Locoregional recurrence after cystectomy in muscle invasive bladder cancer: Implications for adjuvant radiotherapy. Urol Oncol. 2021;39(8):496.e9–496.e15. doi: 10.1016/j.urolonc.2021.01.015