Gynecologic-tract sparing radical cystectomy with long term result: report of 55 cases / 中华泌尿外科杂志

ABSTRACT

ObjectiveTo report a series of female patients with bladder cancer who underwent gynecologic-tract sparing radical cystectomy with long term follow-up.MethodsFifty-five female patients between the ages of 25 and 82 years who underwent gynecologic-tract sparing radical cystectomy between 1990 and 2010 were reviewed retrospectively.Pathologic characteristics and survival ( overall and cancerspecific) were reported.Survival was estimated using Kaplan-Meier methods,and Cox proportional hazards regression analyses were performed to determine factors associated with mortality.ResultsFive patients were lost in follow up.Fifty-five women with a mean follow-up of 55.2 months were analyzed.The 3,5 and 10-year cancer specific survival (CSS) was 65％,61％ and 61％,respectively,and the corresponding overall survival (OS) was 61％,54％ and 42％,respectively.For patients with organ confined disease ( ≤ pT2N0M0) the 5-year CSS and OS was 84％ and 72％,while for those with non organ confined disease ( ≥pT3N0M0) the 5-year CSS and OS reduced to 29％ and 29％.Pathologic lymph node status (HR =3.877,P =0.019) and pathologic staging ( HR =3.992,P =0.011 ) were the only clinical or pathologic characteristics significantly associated with survival.ConclusionsFor patients with pathologically organ-confined bladder cancer ( ≤ pT2 N0 M0 ),gynecologic-tract sparing radical cystectomy is an oncologically safe treatment modality,while for those with ≥ pT3N0M0 or positive pelvic lymph nodes,gynecologic-traet sparing radical cystectomy may need large scale randomized control trials to justify its validity,pathological stage and lymph node status are the most important key points when choosing appropriate patients.