Oncological and functional outcomes of radical cystectomy and orthotopic bladder replacement in women

Glen Yang, Jared M Whitson, Benjamin N. Breyer, Badrinath R. Konety, Peter R. Carroll

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: To report oncological and functional results in women undergoing radical cystectomy and orthotopic bladder replacement. Materials and Methods: The charts of all women undergoing bladder replacement after radical cystectomy at UCSF through April 2008 were reviewed. Pathologic characteristics, survival (overall and disease-specific), and urinary functional outcomes are reported. Survival was estimated using Kaplan-Meier methods, and Cox proportional hazards regression analyses were performed to determine factors associated with incontinence, retention, and mortality. Results: Fifty-six women with a mean follow-up of 35 months were analyzed. The cancer recurrence rate was 32%. Kaplan-Meier estimated 5-year recurrence-free, cancer-specific, and overall survival were 54%, 57%, and 47%, respectively. Pathologic lymph node status (HR 14.2, P <.001) and age at diagnosis (HR 1.7, P = .04) were the only clinical or pathologic characteristics significantly associated with survival. The overall continence rate (no pads) was 57%. Hypercontinence occurred in 24% of patients. Conclusions: With careful patient selection and usage of urethral frozen section, rates of local recurrence are low. Overall rates of incontinence (43%) and hypercontinence (24%) are similar to those previously reported. When pathologically organ-confined, women have an excellent disease-specific survival. Orthotopic bladder replacement is a safe and effective form of urinary diversion after radical cystectomy in women.

Original languageEnglish (US)
Pages (from-to)878-883
Number of pages6
JournalUrology
Volume77
Issue number4
DOIs
StatePublished - Apr 2011
Externally publishedYes

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Cystectomy
Urinary Bladder
Survival
Recurrence
Urinary Diversion
Frozen Sections
Patient Selection
Neoplasms
Lymph Nodes
Regression Analysis
Mortality

ASJC Scopus subject areas

  • Urology

Cite this

Oncological and functional outcomes of radical cystectomy and orthotopic bladder replacement in women. / Yang, Glen; Whitson, Jared M; Breyer, Benjamin N.; Konety, Badrinath R.; Carroll, Peter R.

In: Urology, Vol. 77, No. 4, 04.2011, p. 878-883.

Research output: Contribution to journalArticle

Yang, Glen ; Whitson, Jared M ; Breyer, Benjamin N. ; Konety, Badrinath R. ; Carroll, Peter R. / Oncological and functional outcomes of radical cystectomy and orthotopic bladder replacement in women. In: Urology. 2011 ; Vol. 77, No. 4. pp. 878-883.
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