scholarly journals Gynecologic organ involvement and incidental gynecologic organ neoplasms in female patients with urothelial carcinoma of the bladder undergoing anterior pelvic exenteration in Rajavithi Hospital

2021 ◽  
Vol 42 (2) ◽  
pp. 97-102
Author(s):  
Keerati i Wattanayingcharoencha ◽  
◽  
Chawawat Gosrisirikul ◽  
Keyword(s):  
Urothelial Carcinoma ◽  
Pelvic Exenteration ◽  
Transitional Cell ◽  
Organ Involvement ◽  
Female Patients ◽  
Increased Risk ◽  
Gynecologic Tumor ◽  
Gynecologic Tumors ◽  
Carcinoma Of The Bladder ◽  
Organ Invasion

Objective: To evaluate the pathological data of the bladder and gynecologic organs obtained from anterior pelvic exenteration and review the incidence of gynecologic organ involvement and primary gynecologic tumor. Materials and Methods: The clinicopathological data of 70 patients who were diagnosed with bladder transitional cell carcinoma and underwent anterior pelvic exenteration in Rajavithi Hospital between January 2008 and October 2020 were analyzed to examine and determine any correlations. Results: Thirteen (18.5%) patients had gynecologic organ involvement. This consisted of 4 cases (5.7%) involving the uterus, 7 (10%) involving the vagina, 2 (2.8%) involving the ovaries, and 10 (14.2%) involving the cervix. Female patients with gynecologic organ invasion were more likely to have a high pathological T stage (p < 0.001), and have pre-operative hydronephrosis (p = 0.002). From multivariate logistic regression, pre-operative hydronephrosis was associated with increased risk of gynecologic organ invasion (odds ratio 9.57; 95% confidence interval, 1.86 - 49.18; p = 0.007). There were 23 (32%) female patients incidentally diagnosed with benign gynecologic tumors, specifically 16 (22%) cases of myoma uteri, 7 (10%) of adenomyosis and 4 (2.8%) with ovarian cysts. No patient was diagnosed as having primary gynecologic malignancy. Conclusions: The incidence of gynecologic organ involvement in female patients who had undergone anterior pelvic exenteration for urothelial carcinoma of the bladder was 18.5%. Pre-operative hydronephrosis was a risk factor associated with increased risk of gynecologic organ involvement. Information from this study may allow better identification of candidates for gynecologic organ sparing surgery.

scholarly journals Metastatic Transitional Cell Carcinoma of the Bladder to the Testis: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
Gregory N. Kozak ◽  
Nicholas C. Field
Keyword(s):  
Urothelial Carcinoma ◽  
Lymphovascular Invasion ◽  
Transitional Cell ◽  
Bladder Neck Contracture ◽  
Gross Hematuria ◽  
Metastatic Urothelial Carcinoma ◽  
Poorly Differentiated ◽  
Papillary Urothelial Carcinoma ◽  
Carcinoma Of The Bladder

An 84-year-old gentleman presented with onset of gross hematuria in September 2010. Follow-up investigations revealed T1 superficially invasive, poorly differentiated, papillary urothelial carcinoma. He subsequently had GreenLight laser for BPH and bladder neck contracture on two occasions. He developed a right hydrocele 16 months after initial presentation and during his hydrocelectomy, a rock-hard right epididymis and testicle were discovered. Pathology revealed metastatic urothelial carcinoma replacing nearly the entire testis with lymphovascular invasion.

scholarly journals Clear-cell variant urothelial carcinoma of the bladder: a case report and review of the literature

Rare Tumors ◽  
2012 ◽  
Vol 4 (4) ◽  
pp. 153-155 ◽  
Author(s):  
Mario W. Kramer ◽  
Mahmoud Abbas ◽  
Stefanie Pertschy ◽  
Jan Ulrich Becker ◽  
Hans-Heinrich Kreipe ◽  
...  
Keyword(s):  
Urothelial Carcinoma ◽  
Clear Cell ◽  
Transitional Cell ◽  
Tumor Burden ◽  
Initial Diagnosis ◽  
Review Of The Literature ◽  
Peritoneal Carcinosis ◽  
Carcinoma Of The Bladder ◽  
Cell Variant ◽  
Clear Cell Variant

Clear cell variants of transitional cell carcinomas (TCC) of the bladder are extremely rare tumors. Only 6 cases have been reported until now. We report of a 67 year old man who presented with fast growing tumor disease. While initial diagnosis showed localized bladder tumor, final histopathology revealed pT4, G3, L1 urothelial carcinoma with clear cell differentiation. No more than 14 weeks after initial diagnosis the patient died from multi-organ failure after unsuccessful salvage laparotomy which showed massive tumor burden within the pelvis and peritoneal carcinosis. This case demonstrated an extremely fast tumor growth. Therefore, patients with clear cell urothelial carcinoma should be treated vigorously and without time delay. We present a case of clear cell variant of TCC which exhibited an extremely aggressive behavior. To our knowledge this is the fifth report of this rare disease.

Comparison between oncological outcomes of primary versus salvage radical cystectomy for urothelial carcinoma of the bladder.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 585-585
Author(s):  
Seyedeh Sanam Ladi Seyedian ◽  
Zhoobin Bateni ◽  
Soroush T. Bazargani ◽  
Daniel Zainfeld ◽  
Jie Cai ◽  
...  
Keyword(s):  
Overall Survival ◽  
Local Recurrence ◽  
Urothelial Carcinoma ◽  
Radical Cystectomy ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Increased Risk ◽  
Significant Difference ◽  
Carcinoma Of The Bladder ◽  
To Receive

585 Background: This study aims to compare oncologic outcomes among patients who underwent salvage radical cystectomy (sRC) for recurrent urothelial carcinoma (UC) of the bladder following radiotherapy (RT) with primary radical cystectomy (pRC). Methods: We retrospectively reviewed the data of 3705 primary consented cystectomy patients of our IRB-approved bladder cancer database from Jan 1971 to June 2017 who underwent radical cystectomy for urothelial carcinoma of the bladder. Clinical and pathological data at the time of both RT and RC was collected. Patients with non-UCs and those receiving radiation for non-UCs were excluded. Multivariate analyses was performed to identify prognostic factors after RC for overall survival and recurrence-free survival. Results: 3050 patients were identified who underwent radical cystectomy for UC of the bladder. Of these, 128 patients (4.2%) underwent sRC following radiotherapy (RT). Patient characteristics including age, BMI, gender, and comorbidities were similar between the groups. Complications rates between the groups were similar at 30 days (43% sRC vs 39% pRC patients, p=0.41) and 90 days (52% sRC vs 48% pRC, p=0.42). Patients receiving sRC were less likely to receive a continent diversion (p<0.001). Five-year overall survival following sRC was 47% in comparison to 63% for those undergoing pRC (p<0.001) (Fig 1). However, no significant difference in five-year recurrence free survival was found (61% sRC vs 68% pRC; p=0.15). On multivariate analysis, sRC (HR 1.37, p=0.048), pathologic tumor stage ≥pT3a (HR 2.6, P < 0.001) and lymph node metastases (HR 2.5, P < 0.001) were associated with increased risk of local recurrence after radical cystectomy. Conclusions: Patients undergoing sRC are less likely to receive a continent urinary diversion and are at increased risk of local recurrence following cystectomy in comparison to patients receiving primary cystectomy.

scholarly journals Gynecological organ involvement at robot-assisted radical cystectomy in females: Is anterior exenteration necessary?

2018 ◽  
Vol 12 (9) ◽  
pp. E398-402 ◽  
Author(s):  
Michelle Whittum ◽  
Ahmed Aly Hussein ◽  
Youssef E. Ahmed ◽  
Hijab Khan ◽  
Collin Krasowski ◽  
...  
Keyword(s):  
Radical Cystectomy ◽  
Bladder Tumour ◽  
Organ Involvement ◽  
Robot Assisted ◽  
Female Patients ◽  
Kaplan Meier ◽  
Tumour Location ◽  
Variant Histology ◽  
Multifocal Disease ◽  
Organ Invasion

Introduction: We aimed to investigate patient and disease variables associated with gynecological organ invasion in females with bladder cancer at the time of robot-assisted radical cystectomy (RARC).Methods: We conducted a retrospective review of female patients who underwent robot-assisted anterior pelvic exenteration (RAAE) between 2005 and 2016. Patients were divided into two groups: those with gynecological organ involvement at RAAE and those without. Data were reviewed for perioperative and pathological outcomes. Kaplan-Meier method was used to depict survival outcomes. Multivariable stepwise regression analysis was performed to identify predictors of gynecological organ involvement.Results: A total of 118 female patients were identified; 17 (14%) showed evidence of gynecological organ invasion at RAAE. Patients with gynecological organ invasion had more lymphovascular invasion at transurethral resection of bladder tumour (TURBT) (82% vs. 46%; p=0.006), trigonal tumours at TURBT (59% vs. 18%; p=0.001), multifocal disease (65% vs. 33%; p=0.01), pN+ (71% vs. 22%; p<0.001), positive surgical margins (24% vs. 4%; p=0.02), and they less commonly demonstrated pure urothelial carcinoma at TURBT (18% vs. 66%; p<0.001). On multivariate analysis, significant predictors of gynecological organ invasion were pN-positive disease (odds ratio [OR] 6.48; 95% confidence interval [CI] 1.64–25.51; p=0.008), trigonal tumour location (OR 5.72; 95% CI 1.39–23.61; p=0.02), and presence of variant histology (OR 18.52; 95% CI 3.32–103.4; p=0.001).Conclusions: Patients with trigonal tumours, variant histology, and nodal involvement are more likely to have gynecological organ invasion at RAAE. This information may help improve counselling of patients and better identify candidates for gynecological organsparing cystectomy.

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