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The risk factor for urethral recurrence after radical cystectomy in patients with transitional cell carcinoma of the bladder.

 Kang Su Cho  ;  Joo Wan Seo  ;  Sung Jin Park  ;  Young Hoon Lee  ;  Young Deuk Choi  ;  Nam Hoon Cho  ;  Seung Choul Yang  ;  Sung Joon Hong 
 UROLOGIA INTERNATIONALIS, Vol.82(3) : 306-311, 2009 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Transitional Cell/epidemiology ; Carcinoma, Transitional Cell/pathology ; Carcinoma, Transitional Cell/surgery* ; Cystectomy* ; Disease-Free Survival ; Humans ; Incidence ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/prevention & control* ; Neoplasm Staging ; Patient Selection ; Proportional Hazards Models ; Prostate/pathology ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; Urethra/pathology* ; Urethral Neoplasms/epidemiology ; Urethral Neoplasms/pathology ; Urethral Neoplasms/prevention & control* ; Urinary Bladder Neoplasms/epidemiology ; Urinary Bladder Neoplasms/pathology ; Urinary Bladder Neoplasms/surgery* ; Urinary Diversion*
Bladder cancer ; Cystectomy ; Transitional cell carcinoma
PURPOSE: We evaluated the incidence and risk factors for urethral recurrence following radical cystectomy and urinary diversion in transitional cell carcinoma.

PATIENTS AND METHODS: A retrospective review was performed of the 412 consecutive patients who underwent radical cystectomy and urinary diversion for transitional cell carcinoma of the bladder between 1986 and 2004. A total of 294 patients were enrolled in this study. We investigated the impact of various clinical and pathological features on urethral recurrence by univariate and multivariate analysis.

RESULTS: Urethral recurrence developed in 13 patients (4.4%) and the 5-year urethral recurrence-free probability was 94.9%. On univariate analysis, positive urethral margin, prostatic stromal invasion, and prostatic urethral involvement had a significant influence on urethral recurrence (p < 0.05). The other clinical and pathological features were not significantly associated with urethral recurrence (p > 0.05). A multivariate Cox proportional hazard model revealed that a positive urethral margin (hazards ratio (HR) = 18.33, p < 0.001), prostatic urethral involvement (HR = 7.95, p < 0.001), and prostatic stromal invasion (HR = 5.80, p = 0.018) were independent risk factors for urethral recurrence.

CONCLUSION: A positive urethral margin is considered an absolute indication for prophylactic urethrectomy. In addition, more careful patient selection is necessary for orthotopic urinary diversion in patients with prostatic urethral involvement and prostatic stromal invasion.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Yang, Seung Choul(양승철)
Lee, Young Hoon(이영훈)
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
Cho, Nam Hoon(조남훈) ORCID logo https://orcid.org/0000-0002-0045-6441
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
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