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 diagnosis of muscle-invasive bladder cancer (MIBC).

Methods: The single-center cohort consisting of patients with RC between 2008 and 2020 was divided into four populations: patients who received immediate eRC within three 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 ≥3cm (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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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.