gms | German Medical Science

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

02. - 04.06.2016, Augsburg

Influence of length of surgery on the cancer specific survival in patients undergoing radical cystectomy for urothelial cell carcinoma of the bladder: A retrospective single centre study

Meeting Abstract

  • J.-F. Jokisch - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • T. Grimm - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • A. Buchner - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • B. Schneevoigt - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • C. 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. DocFV24

doi: 10.3205/16urobay024, urn:nbn:de:0183-16urobay0247

Veröffentlicht: 20. April 2016

© 2016 Jokisch 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 & objectives: Radical cystectomy (RC) with bilateral lymph node dissection is considered the standard curative therapy in muscle-invasive bladder cancer (MIBC) and BCG-refractory non-muscle-invasive bladder cancer (NMIBC) in urothelial cell carcinoma (UCC) of the bladder. RC with subsequent reconstruction of both: Ileal- neobladder (INB) or ileal-conduit (IC) still remains very complex surgical procedures associated with a high morbidity. So far there is only limited data on intraoperative prognostic parameters affecting the cancer specific survival (CSS) of RC concerning the duration of surgery. Therefore the aim of this study was to investigate the influence of length of the surgical procedure in UCC patients on CSS.

Material and methods: Medical records of all patients undergoing RC for UCC in the period from 2004 until 2015 were retrospectively analysed in a urological centre. Both urinary diversions IC and INB were identified. Univariate analysis using logrank test and median duration of surgery as cut-off and multivariate analysis using Cox proportional hazard model including tumour staging (TNMG classification) were performed.

Results: The exact length of the surgical procedure of RC in UCC patients was caputered in n=444 patients undergoing RC with reconstruction of an IC and in n=334 patients receiving a INB after RC. The median length of surgery was 235 min. (100-510 min.) for RC with IC and 228 min. (105 - 468 min.) for RC with INB. Follow-up data were available from 400 patients with IC and from 314 for patients with INB. Univariate analysis concerning length of surgery suggests no significant change in CSS for both RC with IC and RC with INB (p-value=0.559 vs. p-value=0.554). A multivariate analysis of patients undergoing RC including TNMG-classification indicates no significant impact of duration of surgery on CSS for RC with IC (hazard ratio=1.2; 95% confidence interval 0.8-1.7; p=0.459) and RC with INB (hazard ratio=0.6; 95% confidence interval 0.4-1.1; p=0.132).

Conclusion: Therefore this study indicates that the length of the surgical procedure itself is not significantly associated with a change in CSS for both urinary diversions. Consecutively duration of surgery cannot be utilized as an independent prognostic parameter in predicting the CSS in the investigated cohort.