736 Radical cystectomy versus bladder-sparing treatment for patients with muscle-invasive urothelial carcinoma of the urinary bladder: A comparative effectiveness population-based study

2015 ◽  
Vol 14 (2) ◽  
pp. e736
Author(s):  
M. Sun ◽  
A. Larcher ◽  
M. McCormack ◽  
Z. Tian ◽  
L. Valiquette ◽  
...  
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Comparative Effectiveness ◽  
Population Based ◽  
Population Based Study ◽  
Muscle Invasive ◽  
Bladder Sparing

Comparative effectiveness of radical cystectomy versus bladder-sparing treatment for muscle-invasive urothelial carcinoma: A population-based report.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 334-334 ◽  
Author(s):  
Maxine Sun ◽  
Giorgio Gandaglia ◽  
Pierre I. Karakiewicz ◽  
Jim C. Hu ◽  
Simon P. Kim ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Advanced Disease ◽  
Population Based ◽  
Disease Stage ◽  
Treatment Modalities ◽  
Radiation Hazard ◽  
Survival Outcomes ◽  
Significant Difference ◽  
Muscle Invasive

334 Background: Radical cystectomy (RC) represents the standard of care for patients with muscle-invasive urothelial carcinoma of the urinary bladder (UCUB). Alternative organ-conserving treatments such as chemotherapy and/or radiotherapy have gained interest. We sought to compare survival outcomes of patients according to treatment modalities, in a stage-for-stage analysis. Methods: We relied on the Surveillance, Epidemiology, and End Results Medicare-linked database to identify 12,950 patients diagnosed with T2–T4a N0/x M0 UCUB between years 1992 and 2009. Treatment types include RC (n=5207), chemotherapy/radiation (n=2,669), and surveillance (n=5,074). Following instrumental variable analysis, Cox- and competing-risks regression analyses were performed for prediction of overall survival (OS) and cancer-specific mortality (CSM), respectively. All analyses were stratified according to disease stage (T2, T3, T4a). Results: After adjusting for potential confounders, OS was more favorable for RC relative to chemotherapy/radiation (hazard ratio [HR]: 1.57, 95% confidence interval [CI]: 1.02–2.40) or surveillance (HR: 1.82, 95% CI: 1.20–2.78) in patients with T2 UCUB. For the same stage, CSM rates were lower in the surgery group compared to chemotherapy/radiation (HR: 2.05, 95% CI: 1.14–3.67) or surveillance (HR: 1.95, 95% CI: 1.09–3.48). When analyses focused on individuals with more advanced disease (T3–T4a), no statistically significant difference was observed between chemotherapy/radiation relative to RC for both OS and CSM. Conclusions: In the current retrospective population-based cohort, RC was associated with improved survival outcomes relative to its alternative treatment counterparts. However, this effect was only observable in patients with T2 disease. Conversely, no difference between chemotherapy/radiation vs. surgery was noted in patients with more advanced disease stage.

Radical cystectomy for patients with pT4 urothelial carcinoma in a large population-based study

2010 ◽  
Vol 107 (6) ◽  
pp. 905-911 ◽  
Author(s):  
Daniel Liberman ◽  
Ahmed Alasker ◽  
Maxine Sun ◽  
Salima Ismail ◽  
Giovanni Lughezzani ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Large Population ◽  
Population Based ◽  
Population Based Study

scholarly journals Early Experiences with Studer’s Orthotopic Neobladder

2016 ◽  
Vol 14 (1) ◽  
pp. 9-15
Author(s):  
Bharat Bahadur Bhandari ◽  
Bikash Bikram Thapa ◽  
Narayan Thapa ◽  
Bhairab Kumar Hamal
Keyword(s):  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Treatment Option ◽  
Late Complications ◽  
Ileal Neobladder ◽  
Late Morbidity ◽  
Muscle Invasive ◽  
One Year

Introduction: Radical cystectomy and urinary diversion is the standard treatment option for muscle invasive urothelial carcinoma of urinary bladder. We analyzed the complications and functional outcome of 21 consecutive patients who underwent radical cystectomy and studer ileal neobladder substitution.Methods: This was a retrospective study from the review of chart and follow up details of 21 patients who underwent radical cystectomy and Studer ileal neobladder substitution from January 2009 to February 2014. Data obtained were the disease characteristics, both the early and late complications and urinary continence.Results: Total 21 patients were evaluated. 17 patients were available for follow up of one year or more. One patient died secondary to surgery related complications and 2 died due to exacerbation of comorbidities. And one patient lost follow up after one year. The rates of early and late morbidity were 33.3% (7) and 19% (4). Prolonged ileus developed in three patients and urinary tract infection was the most common among early and late complications (2, 8%). Two patients developed anastomotic stricture. Complete day time and night time continence was achieved in 82% (14) and 33.3% (7) respectively. The mean maximum neobladder capacity at end of one year was 345 ml.Conclusions: Outcome of studer’s ileal orhtotopic neobladder in our series is comparable with others. The result of our study is promising and encouraging to pursue it as a primary treatment option for muscle invasive and recurrent urothelial carcinoma of urinary bladder.

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