Does Time Matter in Early Radical Cystectomy? Comparing Outcome, Clinical, and Pathological Characteristics of Immediate versus Deferred Radical Cystectomy.

IF 1.5 4区医学 Q3 UROLOGY & NEPHROLOGY

Urologia Internationalis Pub Date : 2024-12-23 DOI:10.1159/000543235

Yushan Yang, Sonja Holbach, Maximilian Haas, Simon Udo Engelmann, Christopher Gossler, Roman Mayr, Maximilian Burger, Johannes Breyer, Michael Gierth

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引用次数: 0

Abstract

Introduction: Early radical cystectomy (eRC) can be performed for high or very high risk non-muscle-invasive bladder cancer (NMIBC). Whether immediate eRC is beneficial is still unclear. The objective of this study was to compare outcomes between immediate eRC, delayed eRC, and radical cystectomy (RC) at the diagnosis of muscle-invasive bladder cancer (MIBC).

Methods: The single-center cohort consisting of patients with RC between 2008 and 2020 was divided into 4 populations: patients who received immediate eRC within 3 months of diagnosis of NMIBC (IEC), patients who received eRC at recurrence of NMIBC (REC), patients who underwent RC after primary diagnosis of MIBC (primMIBC), and patients with the initial diagnosis of NMIBC who received RC after progression to MIBC (progMIBC).

Results: Among the 463 patients included, 39 had IEC, 58 had REC, 314 had primMIBC, and 53 had progMIBC. No statistically significant differences for OS, CSS, and RFS between the two groups receiving eRC were found. Patients with pT1 tumors (p = 0.003) and tumor size ≥3 cm (p = 0.012) were more likely to receive immediate RC.

Conclusion: Immediate and delayed eRC show comparable survival outcomes. The present study emphasizes the need for accurate risk stratification of patients with NMIBC to identify the most advantageous therapy for individual patients.

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早期根治性膀胱切除术时间重要吗？比较即时与延期根治性膀胱切除术的预后、临床及病理特征。

早期根治性膀胱切除术（eRC）可用于高风险或极高风险的非肌肉浸润性膀胱癌（NMIBC）。即刻eRC是否有益仍不清楚。本研究的目的是比较立即eRC、延迟eRC和根治性膀胱切除术（RC）诊断肌肉浸润性膀胱癌（MIBC）的结果。方法：由2008年至2020年期间的RC患者组成的单中心队列分为四组：NMIBC诊断后三个月内立即接受eRC的患者（IEC）， NMIBC复发时接受eRC的患者（REC），原发性诊断为MIBC后接受eRC的患者（primibc）和原发性诊断为NMIBC后进展为MIBC后接受RC的患者（promibc）。结果：纳入的463例患者中，IEC 39例，REC 58例，primMIBC 314例，programmbc 53例。两组接受eRC的OS、CSS和RFS差异无统计学意义。pT1肿瘤（p=0.003）和肿瘤大小≥3cm （p=0.012）的患者更有可能接受立即RC。结论：即刻和延迟eRC的生存结果相当。本研究强调需要对NMIBC患者进行准确的风险分层，以确定对个体患者最有利的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urologia Internationalis 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.