Urethral recurrence in women with orthotopic bladder substitutes: A multi-institutional study

Gakis, Georgios; Ali-El-Dein, Bedeir; Babjuk, Marko; Hrbáček, Jan; Macek, Petr; Burkhard, Fiona C.; Thalmann, George N.; Shaaban, Atallah A.; Stenzl, Arnulf

doi:10.1016/j.urolonc.2015.01.020

Cited by 25 publications

(15 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the literature, according to single‐centre series, the urethral recurrence rate in women with neobladders ranges between 0.6% and 4.3% . The evidence reviewed here suggests that 0–13% of those having preserving techniques will have a local recurrence.…”

Section: Discussionmentioning

confidence: 85%

“…As shown by Stein et al , patients with an uninvolved bladder neck rarely have urethral involvement of cancer. More recently, in a multicentre study by Gakis et al , it was reported that only the final positive surgical margin was associated with urethral recurrence. In a univariable analysis, involvement of the bladder trigone and positive nodes were not risk factors for urethral recurrence.…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Systematic review of the oncological and functional outcomes of pelvic organ‐preserving radical cystectomy (RC) compared with standard RC in women who undergo curative surgery and orthotopic neobladder substitution for bladder cancer

et al. 2017

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 97%

Systematic review of the oncological and functional outcomes of pelvic organ‐preserving radical cystectomy (RC) compared with standard RC in women who undergo curative surgery and orthotopic neobladder substitution for bladder cancer

et al. 2017

Self Cite

View full text Add to dashboard Cite

show abstract

“…As an alternative technique, cutting the ureters at the crossing with the common iliac arteries, results in a low rate of positive ureteral margins at RC (1.2%) [30]. This practice may obviate the need of sequential resection but necessitates a longer segment of ileum for neobladder reconstruction [31]. …”

Section: Evidence Synthesismentioning

confidence: 99%

Systematic Review on the Fate of the Remnant Urothelium after Radical Cystectomy

et al. 2017

Self Cite

View full text Add to dashboard Cite

Context Urothelial carcinoma is considered a pan-urothelial disease. As such, the remnant urothelium in the upper urinary tract and urethra following radical cystectomy (RC) remains at risk for secondary urothelial tumors (SUTs). Objective To describe the incidence, diagnosis, treatment, and outcomes of patients with SUTs after RC. Evidence acquisition A systematic search was conducted using PubMed database according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to identify studies between 1970 and 2016 reporting on malignant diseases of the urothelium after RC for bladder cancer. The search strategy separated between upper and lower tract urothelial tumors. Evidence synthesis Of a total of 1069 studies, 57 were considered for evidence synthesis. SUTs occured in approximately 4–10% of patients after RC. Carcinoma in situ of the bladder, a history of nonmuscle invasive bladder cancer, and tumor involvement of ther distal ureter are the strongest risk factors for secondary upper tract tumors. Risk factors for secondary urethral tumors represent urothelial malignancy in the prostatic urethra/prostate and bladder neck (in women), nonorthotopic diversions, and positive findings on permanent sections. The majority of patients (84%) with SUTs, presented with urothelial recurrence without evidence of metastasis. Of those, 84.0% were treated with surgery, 10.5% with systemic chemotherapy and/or radiotherapy, and 5.6% with topical chemotherapy and/or immunotherapy. After a median follow-up of 91 mo (range: 26–155), 65.9% of patients died of disease and 21.5% died of other causes. Detection and treatment of SUTs at an asymptomatic stage can reduce the risks of cancer-specfific and overall mortality by 30%. A limitation of the study is that the available data were retrospective. Conclusions SUTs are rare oncological events and most patients have an adverse prognosis despite absence of distant disease at diagnosis. Therefore, surveillance of the remnant urothelium should be implemented for patients with histological features of panurothelial disease as it may improve timely detection and treatment. Patient summary Secondary tumors of the renal pelvis, ureters, and urethra occur in approximately 4–10% of patients after radical removal of the bladder for bladder cancer. These patients’ prognoses are reduced, likely due to delayed diagnosis. Therefore, routine surveillance might be important to detect tumors at an early stage.

show abstract

“…Urothelial carcinoma developing as a site of recurrence following cystectomy for bladder cancer is excluded from most studies of primary urethral carcinoma . Urothelial carcinoma of the urethra is much more frequent in this setting compared with primary urothelial carcinoma of urethra arising de novo …”

Section: Resultsmentioning

confidence: 99%

“…17 Urothelial carcinoma of the urethra is much more frequent in this setting compared with primary urothelial carcinoma of urethra arising de novo. 18,19 Because primary carcinoma of the urethra is rare, there are limited data regarding most parameters and their prognostic significance. This is highlighted in the most recent European Association of Urology (EAU) guidelines on the topic that state: 'because primary urethral cancer belongs to a family of rare cancers, most studies are retrospective and recommendations given in these guidelines are mainly based on Level 3 evidence'.…”

Section: S C O P Ementioning

confidence: 99%

Dataset for reporting of carcinoma of the urethra (in urethrectomy specimens): recommendations from the International Collaboration on Cancer Reporting (ICCR)

et al. 2019

View full text Add to dashboard Cite

The International Collaboration on Cancer Reporting (ICCR) is a not‐for‐profit organisation sponsored by the Royal Colleges of Pathologists of Australasia and the United Kingdom, the College of American Pathologists, the Canadian Association of Pathologists in association with the Canadian Partnership Against Cancer, the European Society of Pathology, the American Society of Clinical Pathology and the Faculty of Pathology, Royal College of Physicians of Ireland. Its goal is to produce standardised, internationally agreed‐upon, evidence‐based datasets for cancer pathology reporting throughout the world. This paper describes the development of a cancer dataset by the multidisciplinary ICCR expert panel for the reporting of carcinoma of the urethra in urethrectomy specimens. The dataset is composed of ‘required’ (mandatory) and ‘recommended’ (non‐mandatory) elements, which are based on a review of the most recent evidence and supported by explanatory commentary. Fourteen required elements and eight recommended elements were agreed by the international dataset authoring committee to represent the essential/required (core) and recommended (non‐core) information for the reporting of carcinoma of the urethra in urethrectomy specimens. Use of an internationally agreed, structured pathology dataset for reporting carcinoma of the urethra (in urethrectomy specimens) will provide the necessary information for optimal patient management, will facilitate consistent data collection and will provide valuable data for research and international benchmarking. The dataset will be valuable for those countries and institutions that are not in a position to develop their own datasets.

show abstract

Urethral recurrence in women with orthotopic bladder substitutes: A multi-institutional study

Cited by 25 publications

References 26 publications

Systematic review of the oncological and functional outcomes of pelvic organ‐preserving radical cystectomy (RC) compared with standard RC in women who undergo curative surgery and orthotopic neobladder substitution for bladder cancer

Systematic review of the oncological and functional outcomes of pelvic organ‐preserving radical cystectomy (RC) compared with standard RC in women who undergo curative surgery and orthotopic neobladder substitution for bladder cancer

Systematic Review on the Fate of the Remnant Urothelium after Radical Cystectomy

Dataset for reporting of carcinoma of the urethra (in urethrectomy specimens): recommendations from the International Collaboration on Cancer Reporting (ICCR)

Contact Info

Product

Resources

About