Carcinoma of the Bladder Treated by Segmental Resection

Schoborg, Thomas W.; Sapolsky, Jack L.; Lewis, Charles

doi:10.1016/s0022-5347(17)56469-1

Cited by 38 publications

(4 citation statements)

References 13 publications

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“…Maligned after series from 1970s demonstrated high recurrence rates with poor oncologic outcomes [1][2][3], partial cystectomy has experienced resurgence as a less morbid and oncologically effective treatment. Maligned after series from 1970s demonstrated high recurrence rates with poor oncologic outcomes [1][2][3], partial cystectomy has experienced resurgence as a less morbid and oncologically effective treatment.…”

Section: Introductionmentioning

confidence: 99%

Organ-sparing surgery in urology

Knoedler

Frank

2015

Current Opinion in Urology

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Section: Introductionmentioning

confidence: 99%

Organ-sparing surgery in urology

Knoedler

Frank

2015

Current Opinion in Urology

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“…Early PC series produced questionable outcomes and tempered eagerness to pursue it as a bladder-sparing approach. For series conducted in the 1970s-1980s, 5-year OS rates ranged from 25%-48% (64)(65)(66), while rates of local recurrence remained high around 54-78% (67)(68)(69). Latter PC series with more defined patient selection criteria revealed promising outcomes comparable to RC, although most series had small sample sizes.…”

Section: Partial Cystectomymentioning

confidence: 99%

Bladder preservation in muscle-invasive bladder cancer: a comprehensive review

Hamad¹,

McCloskey²,

Milowsky³

et al. 2020

Int. braz j urol.

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Background: Standard management of muscle-invasive bladder cancer involves radical cystectomy with pelvic lymph node dissection. However, patients may be ineligible for surgery or may wish to avoid the morbidity of cystectomy due to quality of life concerns. Bladder preservation therapies have emerged as alternatives treatment options that can provide comparable oncologic outcomes while maintaining patients' quality of life. Objective: To review bladder preservation therapies, patient selection criteria, and functional and oncologic outcomes for BPT in muscle-invasive bladder cancer. Materials and Methods: We conducted a comprehensive literature review of bladder preservation therapies in Pubmed and Embase. Discussion: The ideal patient for BPT has low-volume T2 disease, absence of CIS, absence of hydronephrosis, and a maximal TURBT with regular surveillance. Technological advancements involving cancer staging, TURBT technique, and chemotherapy and radiation therapy regimens have improved BPT outcomes, with oncologic outcomes now comparable to those of radical cystectomy. Advancements in BPT also includes a heightened focus on improving quality of life for patients undergoing bladder preservation. Preservation strategies with most evidence for use include trimodality therapy and partial cystectomy with pelvic lymph node dissection. Conclusions: This review highlights the breadth of strategies that aim to preserve a patient's bladder while still optimizing local tumor control and overall survival. Future areas for innovation include the use of predictive biomarkers and implementation of immunotherapy, moving the fi eld towards patient-tailored care.

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“…Partial cystectomy (PC), a comparably shorter, less morbid surgery without the need for urinary diversion, was plagued by early reports of high recurrence rates and poor oncological outcomes . While once considered a vastly inferior surgery, a growing body of literature suggests that in properly selected patients, PC can be a suitable alternative to RC, offering quality‐of‐life benefits without compromising survival .…”

Section: Introductionmentioning

confidence: 99%

Robot‐assisted partial cystectomy: perioperative outcomes and early oncological efficacy

et al. 2016

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ObjectiveTo report on patients undergoing robot-assisted partial cystectomy (RAPC), focusing on perioperative outcomes over a range of clinical, anatomical and pathological variables, as well as the overall oncological efficacy of this approach. Patients and MethodsWe retrospectively reviewed all patients who underwent RAPC by a single surgeon between 2005 and 2015. We identified 29 patients who underwent surgery for definitive management of a primary bladder tumour. Clinicopathological data and perioperative variables were recorded. Continuous variables were compared using the Student's t-test. Prediction of perioperative outcomes for those undergoing RAPC for intra-diverticular neoplasms was done using univariate logistic regression. Survival was estimated using the Kaplan-Meier method. ResultsThe median (interquartile range) patient age was 75 (65-81) years, 18 patients (62.1%) had an American Society of Anesthesiologists classification of ≥3, and 10 patients (34.5%) had a history of prior abdominal surgery. The median estimated blood loss (EBL) was 50 mL and the median length of stay (LOS) was 1 day. Two patients (6.9%) had a perioperative complication and five (17.9%) a post-discharge complication at ≤90 days, all of which were minor. The positive surgical margin rate was 3.6% and in those with muscle-invasive disease a median of 12 lymph nodes were removed. Neither the size of diverticulum nor the need for ureteric re-implantation was predictive of LOS, EBL, or complication (P > 0.05). We did not encounter any wound, port site, or unusual recurrence patterns to suggest the technical factors of a robotic approach influenced oncological outcomes. The 5-year overall and recurrence-free survival rates were 79% and 68%, respectively. ConclusionRAPC confers the ability to achieve favourable outcomes with low morbidity and reduced hospital stays. Oncological efficacy compares favourably with the published literature. For experienced surgeons, this may represent the optimal surgical approach for organ-preserving bladder surgery.

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Carcinoma of the Bladder Treated by Segmental Resection

Cited by 38 publications

References 13 publications

Organ-sparing surgery in urology

Organ-sparing surgery in urology

Bladder preservation in muscle-invasive bladder cancer: a comprehensive review

Robot‐assisted partial cystectomy: perioperative outcomes and early oncological efficacy

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