Cystectomy survival outcomes: A single centre experience in Australia

Abstract

Objective: Survival following cystectomy is influenced by gender, age and initial pathology. We report on variation in biopsy versus final surgical pathology and its impact on survival, five year survival of those undergoing cystectomy for bladder urothelial carcinoma, and evaluate any difference between gender and age.Methods: Patients were selected from our hospital cancer database who underwent a cystectomy for bladder urothelial carcinoma between 1987 and 2015. Patients were considered as having bladder cancer if they had muscle invasive cancer, non-muscle invasive cancer or carcinoma in situ on their final biopsy pathology. Pathology was recorded at last cystoscopy before surgery and based on surgical specimen.Results: One hundred and twenty-five patients were included, 71% male, and 29% female, with a median age at cystectomy of 67.1 years. Fifty-seven point nine percent of patients had no change between their biopsy and cystectomy histopathology and 18.3% of patients were downgraded, 16.6% of patients were upgraded, and 7.1% had incomplete pathology data. Median survival was 4.6 years and overall five year survival 58.2%. There was no significant difference in survival between genders and no difference when comparing between gender and age > 70 and < 70 years. There was no statistical difference in survival between patients who had their final pathology upgraded, downgraded, or confirmed.Conclusions: We found lower rates of variation in biopsy versus surgical pathology than reported elsewhere and did not observe a significant association with survival. Our survival outcomes are similar to those within the literature. Gender did not impact on survival, even when comparing between age > 70 and < 70 years.