Investigating the Potential to Offer Reproductive Organ Preserving Radical Cystectomy to More Female Bladder Cancer Patients

IF 2.3 3区医学 Q3 ONCOLOGY

Clinical genitourinary cancer Pub Date : 2025-01-13 DOI:10.1016/j.clgc.2025.102303

Nina Pappot, Sophia Liff Maibom, Maja Vejlgaard, Ulla Nordström Joensen

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引用次数: 0

Abstract

Introduction

Traditional radical cystectomy (tRC) in female bladder cancer (BC) patients includes removal of the ovaries, uterus, and anterior vaginal wall. Reproductive organ preserving radical cystectomy (ROPRC) offers less invasive surgery with comparable survival and better functional outcomes for selected patients. The objective of this study is to investigate the current number of ROPRC at our institution and the potential for increased adoption of the procedure based on precystectomy assessment criteria.

Patients and methods

A retrospective cohort study of female patients treated with radical cystectomy between 2017 and 2021 at a single high volume academic center in Denmark. Suspicion of stage T4 was assessed based on precystectomy CT, transurethral resection of bladder tumor with bimanual palpation, and intraoperative assessment at cystectomy. Median follow-up was 36 months for both tRC and ROPRC. The primary outcome was number of ROPRC. The secondary outcome was potential for ROPRC in the tRC population. Frequencies and predictive values were calculated.

Results

A total of 118 female BC patients were included. Four patients underwent ROPRC, all with non–muscle-invasive BC. None had local recurrence. In tRC (n = 114), stage T4 BC was suspected in 31% (35/114) and 14% (16/114) had pT4 at final pathology. There was no suspicion of stage T4 BC in 83 patients, and 82 of these had <pT4 at final pathology, providing a negative predictive value for identifying stage T4 BC before pathology of 99%. The potential for ROPRC in the tRC population was 69% (79/114). Limitations were the retrospective single center study and limited number of ROPRC.

Conclusions

Only 4 women over a 5-year period underwent complete or partial ROPRC. The preoperative prediction of stage T4 was accurate, which could reflect a potential to offer ROPRC to more than two thirds of female cystectomy patients currently undergoing tRC.

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来源期刊

Clinical genitourinary cancer 医学-泌尿学与肾脏学

CiteScore

5.20

自引率

6.20%

发文量

201

审稿时长

54 days

期刊介绍： Clinical Genitourinary Cancer is a peer-reviewed journal that publishes original articles describing various aspects of clinical and translational research in genitourinary cancers. Clinical Genitourinary Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of genitourinary cancers. The main emphasis is on recent scientific developments in all areas related to genitourinary malignancies. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.