ABSTRACT
Objective To evaluate the risk factors of urethral recurrences following radical cystectomy for transitional cell carcinoma of the bladder and to discuss the treatment options. Methods Clinical data of 278 patients who underwent radical cystectomy for bladder cancer were analyzed retrospectively. Urethral recurrences were observed in 24 patients. Risk factors of recurrence were evaluated by Cox's multifactor regression model. Results None of the 6 patients undergoing selective prophylactic urethrectomy died;10 of the 24 patients with urethral recurrence died of tumor metastasis.Multiple factor analysis suggested that prostate involvement,bladder neck involvement,trigone tumor,multiple tumor and carcinoma in situ were the high risk factors,and their relative risk coefficients were 1.573,1.532,1.360, 1.337 and 1.213,respectively. Conclusions Simultaneous urethrectomy following radical cystectomy should be performed for patients with high risk factors (prostate involvement, bladder neck involvement, trigone tumor,multiple tumor and carcinoma in situ) of urethral recurrence,while patients without risk factors are eligible candidates for reconstruction of the urinary tract after cystectomy by an orthotopic neobladder.