These results demonstrate that contemporary radical cystectomy can be accomplished through an open operative approach consistently with acceptable morbidity/mortality and with a median length of stay of less than 1 week. Efforts to further reduce morbidity and improve outcomes should continue.
In the largest series to date of patients with MCDK and contralateral VUR we found that spontaneous resolution in a relatively short period can be anticipated for most children. Furthermore, VUR is not a significant threat to the growth of the solitary renal unit in the first few years of life.
There was a significant trend toward the more liberal use of ileal conduit urinary diversion. Patients with female gender, advanced age, significant medical comorbidity or locally advanced disease were less likely to undergo neobladder urinary diversion. This trend is partly explained by surgeon preference combined with an aging, more comorbid patient population. Neobladder continues to be the most commonly performed urinary diversion in patients younger than 65 years.
In this series no significant difference was noted in overall, disease specific and recurrence-free survival when comparing lymph node negative pT2a vs pT2b urothelial cancer of the bladder following radical cystectomy. Future revisions of the American Joint Committee on Cancer staging system may consider simplifying pathological staging by consolidating these substages.
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