The risk factor for urethral recurrence after radical cystectomy in patients with transitional cell carcinoma of the bladder

Kang Su Cho, Joo Wan Seo, Sung Jin Park, Young Hoon Lee, Youngdeuk Choi, Namhoon Cho, Seung Choul Yang, Sung Joon Hong

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Purpose: We evaluated the incidence and risk factors for urethral recurrence following radical cystectomy and urinary diversion in transitional cell carcinoma. Patients and Methods: A retrospective review was performed of the 412 consecutive patients who underwent radical cystectomy and urinary diversion for transitional cell carcinoma of the bladder between 1986 and 2004. A total of 294 patients were enrolled in this study. We investigated the impact of various clinical and pathological features on urethral recurrence by univariate and multivariate analysis. Results: Urethral recurrence developed in 13 patients (4.4%) and the 5-year urethral recurrence-free probability was 94.9%. On univariate analysis, positive urethral margin, prostatic stromal invasion, and prostatic urethral involvement had a significant influence on urethral recurrence (p < 0.05). The other clinical and pathological features were not significantly associated with urethral recurrence (p > 0.05). A multivariate Cox proportional hazard model revealed that a positive urethral margin (hazards ratio (HR) = 18.33, p < 0.001), prostatic urethral involvement (HR = 7.95, p < 0.001), and prostatic stromal invasion (HR = 5.80, p = 0.018) were independent risk factors for urethral recurrence. Conclusion: A positive urethral margin is considered an absolute indication for prophylactic urethrectomy. In addition, more careful patient selection is necessary for orthotopic urinary diversion in patients with prostatic urethral involvement and prostatic stromal invasion.

Original languageEnglish
Pages (from-to)306-311
Number of pages6
JournalUrologia Internationalis
Volume82
Issue number3
DOIs
Publication statusPublished - 2009 May 1

Fingerprint

Transitional Cell Carcinoma
Cystectomy
Urinary Bladder
Recurrence
Urinary Diversion
Proportional Hazards Models
Patient Selection
Multivariate Analysis
Incidence

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Cho, Kang Su ; Seo, Joo Wan ; Park, Sung Jin ; Lee, Young Hoon ; Choi, Youngdeuk ; Cho, Namhoon ; Yang, Seung Choul ; Hong, Sung Joon. / The risk factor for urethral recurrence after radical cystectomy in patients with transitional cell carcinoma of the bladder. In: Urologia Internationalis. 2009 ; Vol. 82, No. 3. pp. 306-311.
@article{894879c7ab0543bcac7e481716e4e26f,
title = "The risk factor for urethral recurrence after radical cystectomy in patients with transitional cell carcinoma of the bladder",
abstract = "Purpose: We evaluated the incidence and risk factors for urethral recurrence following radical cystectomy and urinary diversion in transitional cell carcinoma. Patients and Methods: A retrospective review was performed of the 412 consecutive patients who underwent radical cystectomy and urinary diversion for transitional cell carcinoma of the bladder between 1986 and 2004. A total of 294 patients were enrolled in this study. We investigated the impact of various clinical and pathological features on urethral recurrence by univariate and multivariate analysis. Results: Urethral recurrence developed in 13 patients (4.4{\%}) and the 5-year urethral recurrence-free probability was 94.9{\%}. On univariate analysis, positive urethral margin, prostatic stromal invasion, and prostatic urethral involvement had a significant influence on urethral recurrence (p < 0.05). The other clinical and pathological features were not significantly associated with urethral recurrence (p > 0.05). A multivariate Cox proportional hazard model revealed that a positive urethral margin (hazards ratio (HR) = 18.33, p < 0.001), prostatic urethral involvement (HR = 7.95, p < 0.001), and prostatic stromal invasion (HR = 5.80, p = 0.018) were independent risk factors for urethral recurrence. Conclusion: A positive urethral margin is considered an absolute indication for prophylactic urethrectomy. In addition, more careful patient selection is necessary for orthotopic urinary diversion in patients with prostatic urethral involvement and prostatic stromal invasion.",
author = "Cho, {Kang Su} and Seo, {Joo Wan} and Park, {Sung Jin} and Lee, {Young Hoon} and Youngdeuk Choi and Namhoon Cho and Yang, {Seung Choul} and Hong, {Sung Joon}",
year = "2009",
month = "5",
day = "1",
doi = "10.1159/000209363",
language = "English",
volume = "82",
pages = "306--311",
journal = "Urologia Internationalis",
issn = "0042-1138",
publisher = "S. Karger AG",
number = "3",

}

The risk factor for urethral recurrence after radical cystectomy in patients with transitional cell carcinoma of the bladder. / Cho, Kang Su; Seo, Joo Wan; Park, Sung Jin; Lee, Young Hoon; Choi, Youngdeuk; Cho, Namhoon; Yang, Seung Choul; Hong, Sung Joon.

In: Urologia Internationalis, Vol. 82, No. 3, 01.05.2009, p. 306-311.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The risk factor for urethral recurrence after radical cystectomy in patients with transitional cell carcinoma of the bladder

AU - Cho, Kang Su

AU - Seo, Joo Wan

AU - Park, Sung Jin

AU - Lee, Young Hoon

AU - Choi, Youngdeuk

AU - Cho, Namhoon

AU - Yang, Seung Choul

AU - Hong, Sung Joon

PY - 2009/5/1

Y1 - 2009/5/1

N2 - Purpose: We evaluated the incidence and risk factors for urethral recurrence following radical cystectomy and urinary diversion in transitional cell carcinoma. Patients and Methods: A retrospective review was performed of the 412 consecutive patients who underwent radical cystectomy and urinary diversion for transitional cell carcinoma of the bladder between 1986 and 2004. A total of 294 patients were enrolled in this study. We investigated the impact of various clinical and pathological features on urethral recurrence by univariate and multivariate analysis. Results: Urethral recurrence developed in 13 patients (4.4%) and the 5-year urethral recurrence-free probability was 94.9%. On univariate analysis, positive urethral margin, prostatic stromal invasion, and prostatic urethral involvement had a significant influence on urethral recurrence (p < 0.05). The other clinical and pathological features were not significantly associated with urethral recurrence (p > 0.05). A multivariate Cox proportional hazard model revealed that a positive urethral margin (hazards ratio (HR) = 18.33, p < 0.001), prostatic urethral involvement (HR = 7.95, p < 0.001), and prostatic stromal invasion (HR = 5.80, p = 0.018) were independent risk factors for urethral recurrence. Conclusion: A positive urethral margin is considered an absolute indication for prophylactic urethrectomy. In addition, more careful patient selection is necessary for orthotopic urinary diversion in patients with prostatic urethral involvement and prostatic stromal invasion.

AB - Purpose: We evaluated the incidence and risk factors for urethral recurrence following radical cystectomy and urinary diversion in transitional cell carcinoma. Patients and Methods: A retrospective review was performed of the 412 consecutive patients who underwent radical cystectomy and urinary diversion for transitional cell carcinoma of the bladder between 1986 and 2004. A total of 294 patients were enrolled in this study. We investigated the impact of various clinical and pathological features on urethral recurrence by univariate and multivariate analysis. Results: Urethral recurrence developed in 13 patients (4.4%) and the 5-year urethral recurrence-free probability was 94.9%. On univariate analysis, positive urethral margin, prostatic stromal invasion, and prostatic urethral involvement had a significant influence on urethral recurrence (p < 0.05). The other clinical and pathological features were not significantly associated with urethral recurrence (p > 0.05). A multivariate Cox proportional hazard model revealed that a positive urethral margin (hazards ratio (HR) = 18.33, p < 0.001), prostatic urethral involvement (HR = 7.95, p < 0.001), and prostatic stromal invasion (HR = 5.80, p = 0.018) were independent risk factors for urethral recurrence. Conclusion: A positive urethral margin is considered an absolute indication for prophylactic urethrectomy. In addition, more careful patient selection is necessary for orthotopic urinary diversion in patients with prostatic urethral involvement and prostatic stromal invasion.

UR - http://www.scopus.com/inward/record.url?scp=65949119997&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=65949119997&partnerID=8YFLogxK

U2 - 10.1159/000209363

DO - 10.1159/000209363

M3 - Article

C2 - 19440019

AN - SCOPUS:65949119997

VL - 82

SP - 306

EP - 311

JO - Urologia Internationalis

JF - Urologia Internationalis

SN - 0042-1138

IS - 3

ER -