Partial cystectomy for urothelial carcinoma of the bladder: Practice patterns and outcomes in the general population
DOI:
https://doi.org/10.5489/cuaj.4403Abstract
Introduction: Partial cystectomy (PC) for urothelial carcinoma (UC) in selected patients may avoid the morbidity of radical cystectomy (RC). We describe use and outcomes of PC for UC in routine clinical practice.
Methods: All patients with urothelial carcinoma of the bladder (UCB) undergoing PC or RC in Ontario from 1994‒2008 were identified using the Ontario Cancer Registry and linked electronic records. Pathology reports were reviewed. Variables associated with PC use were identified using logistic regression. Cox proportional hazards model identified factors affecting cancer-specific (CSS) and overall survival (OS).
Results: A total of 3320 patients underwent PC (n=181; 5%) or RC (n=3139; 95%) from 1994‒2008. PC patients were older (36% 80+ years vs. 19%; p<0.001) and more likely to have organ-confined (&lh;pT3) disease (54% vs. 36% RC; p<0.001). Two-thirds (67%) of PC patients did not undergo lymph node dissection (24% for RC; p<0.001). Factors associated with having PC included older age (odds ratio [OR] 1.55; 95% confidence interval [CI] 0.96‒2.51 for 70+ years), moderate comorbidity (OR 1.95; 95% CI 1.13‒3.37), and surgery outside of a comprehensive cancer centre (OR 1.44; 95% CI 1.03‒2.01). Unadjusted five-year OS for PC and RC cases was 34% and 33%, respectively (p=0.455); CSS at five years was 43% and 37% (p=0.045). On adjusted analysis, PC was associated with comparable CSS (hazard ratio [HR] 0.87, 95% CI 0.70‒1.09) and OS (HR 0.95, 95% CI 0.79‒1.14) as RC.
Conclusions: In routine clinical practice, PC is not common. A substantial proportion of patients treated with PC achieve longterm survival. PC remains a treatment option in selected patients with UCB.
Downloads
Downloads
Published
How to Cite
Issue
Section
License
You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA:
- Post the Article on any Web site
- Translate or authorize a translation of the Article
- Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so
- Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so.
The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request.
You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article.
The CUA also requires you to warrant the following:
- That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party;
- That all individuals who have made a substantive contribution to the article are acknowledged;
- That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and
- That the Article does not libel or violate the privacy rights of any third party.