Local recurrence after cystectomy alone for bladder carcinoma

Abstract

Although the role of preoperative irradiation in the treatment of bladder carcinoma is questioned, patterns of failure after cystectomy alone are not well documented. Local failure patterns were analyzed retrospectively in 83 patients (67 men and 16 women) treated with cystectomy without adjuvant therapy at three institutions. The follow‐up period ranged from 0 to 167 months. Disease was assessed preoperatively by clinical stage and postoperatively by pathologic stage. Thirteen patients had pelvic recurrences, a 5‐year actuarial failure rate of 18%. Pathologic stage was the only significant predictor of local recurrence, which ranged from 6% in patients with pT2 tumors to 51% in patients with pT3b tumors. The median time to local recurrence was 9 months (range, 3 to 62 months). Clearer documentation of failure patterns will provide a basis for evaluating survival with combined treatment methods, including preoperative radiation therapy, surgery, and chemotherapy.

Patterns, risks and outcomes of urethral recurrence after radical cystectomy for urothelial cancer; over 20 year single center experience

“…In general, pathological stage and lymph node involvement during the initial diagnosis are the most important factors of prognosis and these two factors are closely related with local and systemic recurrences [16,17]. Again, pathological stage is shown to be an important factor in urethral recurrence rates [18,19].…”

Bladder cancer and schistosomiasis

“…Similarly, the incidence of distant metastasis in urothelial cancer ranged from 12% to 35% [42,43]. Loco-regional recurrence with or without distant metastasis was found in 5-31% of the patients treated with RC, depending on their pathological and clinical features [44]. Factors associated with local recurrence are mostly the same as those determining distant metastasis, namely pathologic tumor stage, grade and regional nodal involvement together with the lymphadenectomy extent.…”

“…Factors associated with local recurrence are mostly the same as those determining distant metastasis, namely pathologic tumor stage, grade and regional nodal involvement together with the lymphadenectomy extent. Rates of local recurrence were reported in SNA-BC as 6, 18 and 51% in patients with stage pT1, pT2 and pT3, respectively [44]. Another SNA-BC study showed that the 5-year local recurrence rate reached 11, 23 and 31% for stages II, III and IV, respectively [45].…”

Multimodality Therapy Including Surgical Resection and Intraoperative Electron Radiotherapy for Recurrent or Advanced Primary Carcinoma of the Urinary Bladder or Ureter

“…2 However, in patients presenting with LR advanced disease (extravesicular tumor spread and/or pelvic lymph node involvement), there is substantial risk of LR recurrence or distant metastasis after radical cystectomy. [2][3][4][5][6] Patients with LR tumor recurrence have median survival duration of 4 to 7 months, 3,4,6,7 and may experience significant morbidity for much of their remaining lifespan. Thus, there is a need for treatment strategies that prevent or effectively treat LR recurrence.…”

“…Single modality approaches such as salvage surgery, chemotherapy, or external beam radiotherapy (EBRT) are largely unsuccessful in achieving long-term disease control. 3,4,6,7 Salvage surgery is often difficult because of tumor extension to the pelvic sidewall or adjacent organs. Similarly, salvage EBRT alone is often only palliative, because the tolerance of adjacent normal organs precludes delivery of sufficiently high radiation dose.…”