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42. Gemeinsame Tagung der Bayerischen Urologenvereinigung und der Österreichischen Gesellschaft für Urologie und Andrologie

02. - 04.06.2016, Augsburg

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Radical cystectomy in patients with metastatic urothelial carcinoma of the bladder; results of a single center study

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  • T. Grimm - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • A. Buchner - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • A. Kretschmer - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • B.-S. Schneevoigt - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • M. Apfelbeck - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • M.T. Grabbert - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • F. Jokisch - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • G. Schulz - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • C.G. Stief - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • A. Karl - Ludwig-Maximilians-Universität München, Urologie, München, Germany

Bayerische Urologenvereinigung. Österreichische Gesellschaft für Urologie und Andrologie. 42. Gemeinsame Tagung der Bayerischen Urologenvereinigung und der Österreichischen Gesellschaft für Urologie und Andrologie. Augsburg, 02.-04.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocKV20

doi: 10.3205/16urobay020, urn:nbn:de:0183-16urobay0209

Veröffentlicht: 20. April 2016

© 2016 Grimm et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Introduction: According to current guidelines radical cystectomy (RC) can be considered in patients with urothelial carcinoma of the bladder (UCB) and primary distant metastasis for palliative reasons. However there is only limited data about patient's oncologic outcome in this situation. In our study we analyzed the impact of clinically detected distant metastases at the time of RC on cancer specific survival (CSS) and progression-free survival (PFS) in patients with UCB.

Material and methods: There were 88 patients with clinically suspected distant metastases who underwent palliative RC due to UC from 2004 to 2015 at our institution. More men than woman (75% vs. 25%) underwent surgery with a median age of 68 years (range 44 - 90 years). All included patients presented with the suspicion for distant metastasis in our standard preoperative staging. Median follow up time was 12 months (range 1 - 113 months). CSS was analyzed using Kaplan-Meier method.

Results: In our analysis 67% of our patients (59/88) showed a histological stage of pT3-4; 41% (36/88) were lymph node positive (pN+) and 95% (84/88) presented with high-grade tumors (G3). Median PFS was 7 months; these data were available in 61 patients. Median CSS was 15 months with a 5-year survival rate of 32%. Data were available in 74 patients. Histological stage pT< 3 was significantly associated with longer CSS compared to those with stage pT3-4 (p< 0.001). Furthermore patients classified as lymph node negative (pN0) likewise showed a significant longer CSS than those with pN+ (p>0.001). Histological grading had no significant impact on CSS (G2 vs. G3; p=0.523).

Conclusion: The performance of RC in patients with the clinical suspicion of distant metastases could play a certain role not only for palliative but also for oncologic reasons indicated by a 5 year CSS of 32% in our cohort. A bias of this analysis however could be inaccurate CT/MRI reports and the fact that the status of metastases was captured retrospectively.