Gynecologic Organ Involvement During Radical Cystectomy for Bladder Cancer: Is It Time to Routinely Spare the Ovaries?

Taylor, Benjamin; Matrai, Cathleen; Smith, Ariana L.; Ayangbesan, Abimbola; Xia, Leilei; Golombos, David M.; Mosquera, Juan Miguel; Nicolas, Joseph; Robinson, Brian D.; Scherr, Douglas S.; Khani, Francesca

doi:10.1016/j.clgc.2018.10.009

Cited by 13 publications

(13 citation statements)

References 27 publications

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“…4,6,10 Taylor et al recently reported a 4% rate of ovarian involvement in 123 women undergoing RC for BCa. 21 Of these patients, only one had clinically organ confined, node negative disease prior to RC. The primary impetus for prophylactic oophorectomy stems from the belief that ovarian cancer originates in the ovaries; however, mounting evidence now supports that "ovarian" cancers instead arise from the fallopian tubes.…”

Section: Discussionmentioning

confidence: 99%

Contemporary Rates of Gynecologic Organ Involvement in Females with Muscle Invasive Bladder Cancer: A Retrospective Review of Women Undergoing Radical Cystectomy following Neoadjuvant Chemotherapy

et al. 2021

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Section: Discussionmentioning

confidence: 99%

Contemporary Rates of Gynecologic Organ Involvement in Females with Muscle Invasive Bladder Cancer: A Retrospective Review of Women Undergoing Radical Cystectomy following Neoadjuvant Chemotherapy

et al. 2021

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“…RO involvement occurred in up to 23% of females undergoing standard RC, with vaginal and uterus involvement being the most common (42)(43)(44)(45)(46). This is likely due to the generally late diagnosis of bladder cancer in females.…”

Section: Involvement Of Romentioning

confidence: 99%

“…Regarding ROPRC, two studies found that RO involvement rates were equal or lower compared to standard RC (33,34). Most women with RO involvement have locally advanced bladder cancer with lymphovascular invasion, trigonal tumors, or concomitant non-bladder primary malignancies, however, intraoperative findings of primary malignancies of the RO are rare (34,44,45). Variant histology, tumor in the trigone or bladder neck, a palpable mass, hydronephrosis, and lymph node-positive disease were identified as risk factors for RO involvement (42,45,47).…”

Section: Involvement Of Romentioning

confidence: 99%

Radical cystectomy and urinary diversion in women: techniques, outcomes, and challenges—a narrative review

Deimling¹,

Laukhtina²,

Pradère³

et al. 2022

Transl Androl Urol

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Background and Objective: Standard radical cystectomy (RC) in women includes the removal of the bladder, urethra, uterus with the adnexa, and the anterior vaginal wall, thereby severely affecting the urinary, sexual, and reproductive system. To limit these detrimental effects, organ-sparing, including nerve-sparing approaches, have been developed. Health-related quality of life (HRQOL) and functional outcomes are, indeed, becoming increasingly central to the shared decision-making with the patient. The objectives of this narrative review are: (I) to review the current status of RC in women, including the use of different urinary diversions (UDs); (II) to discuss organ-sparing approaches and their impact on oncological and functional outcomes in women; (III) to discuss the impact of RC on HRQOL and sexual function in women.Methods: We performed a non-systematic literature review of the available publications in the PubMed database.

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“…Taylor et al reported that the presence of gynecologic organ involvement during anterior pelvic exenteration was associated with advanced pathologic T stage. 20 Djaladat et al retrospectively reviewed 267 patients and found that palpable mass and hydronephrosis were among the preoperative clinical factors associated with reproductive organ involvement. 5 Chen et al examined 115 patients and reported that vaginal and cervical invasion both showed a correlation with stages T3b and T4 of disease.…”

Section: Discussionmentioning

confidence: 99%

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

Wattanayingcharoencha¹,

Gosrisirikul²

2021

Insight Urol

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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.

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Gynecologic Organ Involvement During Radical Cystectomy for Bladder Cancer: Is It Time to Routinely Spare the Ovaries?

Cited by 13 publications

References 27 publications

Contemporary Rates of Gynecologic Organ Involvement in Females with Muscle Invasive Bladder Cancer: A Retrospective Review of Women Undergoing Radical Cystectomy following Neoadjuvant Chemotherapy

Contemporary Rates of Gynecologic Organ Involvement in Females with Muscle Invasive Bladder Cancer: A Retrospective Review of Women Undergoing Radical Cystectomy following Neoadjuvant Chemotherapy

Radical cystectomy and urinary diversion in women: techniques, outcomes, and challenges—a narrative review

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

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