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 Detalle_Publicacion

Predictive factors of evolution of patienes after pTO radical Cystectomy due to bladder cancer

Abstract: Objectives: To analyze the influence of the different pre ? cystectomy factors, both clinical and pathological, in the follow up of patients with no residual tumor ( pT0 ) in the pathological examination of the radical cystectomy specimen as predictors of tumor recurrence. Secondly we intend to compare overall survival, disease free survival and cancer-specific survival with the rest of cystectomy patients in our series. Methods: Between 1985 and 2010, radical cystectomy was performed in 280 patients with bladder cancer, being 41 pT0 (14.6%). We analyzed potential predictors for overall survival and disease-free survival: age, sex , number of transurethral resections of bladder tumor before cystectomy , tumor type , tumor grade, tumor stage, tumor size, number of tumors, associated Cis and previous instillations. We used univariate analysis of Cox regression. Survival analysis was performed using Kaplan ? Meier curves and log-rank test. Results: Mean age was 61.7 years and 37 patients were males (90.2%). Stages before cystectomy were pT1 in eight (19.5%) , pT2 in 31 (75.6%) and Cis in two (4.9 %) with tumor grade III in 37 (90.2%). Cystectomy specimens revealed the presence of papillary transitional cell carcinoma in 38 (92.7%) cases. The median number of pre-cistectomy-TURBT was one. Eleven patients (26.8%) received intravesical instillations. Six patients (14.63 %) had tumor recurrence and 10 (24.4 %) died from causes unrelated to the disease. None of the variables analyzed was statistically significant in the univariate analysis as a predictor of tumor recurrence. With a median follow up of 70 months (3-272) disease-free survival and overall survival at five years were 85.9% and 72.8% respectively. Compared to the non pT0 cystectomies in our series, pT0 had a statistically significant difference for better recurrence-free survival (63.4 % and 36.8%, respectively in pT0 and no-pT0 patients) (p<0,05). Conclusions: According to the results, we have found a better outcome for pT0 patients after cystectomy compared to those with residual tumor. We have not found any pre - cystectomy predictive factor related to disease-free survival and overall survival.

 Fuente: Archivos Españoles de Urología, 2014, 67(9), 764-769

Editorial: Archivos españoles de urología. Iniestares S.A.U.

 Año de publicación: 2014

Nº de páginas: 6

Tipo de publicación: Artículo de Revista

ISSN: 0004-0614,1576-8260

Autoría

ENRIQUE MEDIAVILLA DIEZ

JOSE ANTONIO PORTILLO MARTIN

DAVID TRUAN CACHO

CESAR JESUS CARRION BALLARDO