Practice patterns and recurrence after partial cystectomy for bladder cancer

Abstract

Rate of PC for invasive bladder cancer is significantly higher than expected. Pelvic lymphadenectomy is underutilized in bladder cancer patients treated with PC. Whether prevalent use of PC is due to less stringent selection criteria remains unknown. Since late recurrence is not uncommon, lifelong follow-up is recommended.

A new horizon for bladder preservation in muscle‐invasive bladder cancer

“…When comparing these findings with the bladder cancer recurrence rates after partial cystectomy in the setting of muscle‐invasive disease (~40%) and trimodal bladder preservation therapy (11–19%) , the findings presented in this paper are remarkable. Although the lower recurrence rate observed in this patient series may be influenced by a shorter follow‐up time than other studies looking at similar outcomes in patients treated for muscle‐invasive bladder cancer, the results of this paper demonstrate a promising frontier in bladder cancer treatment, combining the benefits of trimodal therapy with the extirpative intent of surgery while preserving the bladder.…”

Partial cystectomy for urothelial carcinoma of the bladder: Practice patterns and outcomes in the general population

“…Two population-level studies from the United States and from the Canadian province of Quebec found 18-30% of patients underwent PC, however these studies may have included non-urothelial histologies. [10,11]. Moreover, because these studies classified cystectomy based on administrative data sources, they may over-estimate the use of PC due to misclassification bias.…”

“…It is notable that no lymph node pathologic data was available for 67% of PC cases in our series (and 24% of RC), suggesting that PLND was not considered part of the surgical procedure, possibly to decrease operative time and/or morbidity. Prior studies have shown highly variable use of PLND in other settings [8,10,20]. It is clear that PLND is a critical component of definitive surgical management of MIBC from a risk stratification and prognostic perspective, and these data point to a deficit in current practice [3,22,23].…”

“…Partial cystectomy data often includes non-urothelial cancers and are therefore difficult to compare with radical cystectomy. Only a handful of studies have described utilization and outcome of PC in routine clinical practice [7,10,11]. We undertook a population-based retrospective cohort study to describe the use and outcomes of PC in the Canadian province of Ontario.…”

Where are we with bladder preservation for muscle-invasive bladder cancer in 2017?

“…[10] As summarized in Table 1, overall 5-year survival for patients undergoing partial cystectomy for MIBC is between 50% and 70%, with up to 81% of patients retaining their native bladder at 10 years. [910121315192021]…”