Risk factors for urethral recurrence in men after radical cystectomy with orthotopic urinary diversion for urothelial carcinoma: A retrospective cohort study

Dong Hyeon Lee, Wan Song

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Purpose: To evaluate the risk factors affecting urethral recurrence (UR) in men after radical cystectomy (RC) with ileal orthotopic neobladder (IONB). Materials and Methods: We retrospectively reviewed 348 men who underwent RC with IONB for bladder cancer between January 2010 and December 2017. Clinicopathologic characteristics, including tumor location (trigone and/or bladder neck), prostatic urethral and/or stromal involvement, presence of carcinoma in situ (CIS), pathologic T and N stage, and urethral resection margin status, were identified. Kaplan–Meier survival analysis was used to illustrate urethral recurrence-free survival (URFS), and Cox proportional hazard models were applied to identify factors predicting UR. Results: Of the 348 patients, UR was identified in 7 (2.0%) patients during the mean followup of 33.3 months. The 2-, 3-, and 5-year URFS rates were 97.6%, 96.3%, and 93.8%, respectively. On multivariable analysis, prostatic urethral involvement (P = 0.033, hazard ratio: 6.25, 95% confidence interval: 1.06–36.96) was an independent predictor of UR. When patients were divided according to prostatic urethral involvement (negative vs positive), the 2-and 3-year URFS rates were significantly different (93.8% and 96.8%, respectively, vs 92.0% and 92.0%, respectively; P = 0.020). All 7 patients with UR underwent transurethral surgery and maintained their IONB. Conclusion: In this series, UR occurred in approximately 2% of men after RC with IONB. Prostatic urethral involvement was the only significant prognostic factor for UR. Follow-up strategies considering UR risk should be adopted to facilitate early detection in those at high risk of UR.

Original languageEnglish
Pages (from-to)6739-6746
Number of pages8
JournalCancer Management and Research
Volume12
DOIs
StatePublished - 2020

Bibliographical note

Funding Information:
grant funded by the Ministry of Science, ICT & Future Planning (NRF-2018R1C1B6007678).

Funding Information:
This research was supported by the Basic Science Research Program through a National Research Foundation of Korea

Publisher Copyright:
© 2020 Lee and Song.

Keywords

  • Bladder cancer
  • Neobladder
  • Radical cystectomy
  • Risk factor
  • Urethral recurrence

Fingerprint

Dive into the research topics of 'Risk factors for urethral recurrence in men after radical cystectomy with orthotopic urinary diversion for urothelial carcinoma: A retrospective cohort study'. Together they form a unique fingerprint.

Cite this