Article

Outcomes of pT0N0 at radical cystectomy: The Canadian Bladder Cancer Network experience.

Washington University School of Medicine, St. Louis, MO;
Canadian Urological Association journal = Journal de l'Association des urologues du Canada (impact factor: 1.24). 06/2012; 6(3):E116-20. DOI:10.5489/cuaj.11276
Source: PubMed

ABSTRACT : Radical cystectomy is the standard treatment for muscle invasive bladder cancer. We assessed clinical outcomes in patients found to have no evidence of disease (i.e., pT0N0) following radical cystectomy.
: We collected and pooled a database of 2287 patients who underwent radical cystectomy between 1993 and 2008 in eight centres across Canada. Of this number, 135 patients were found to have pT0N0 bladder cancer at the time of cystectomy. Survival data and prognostic variables were analyzed using Kaplan-Meier method and Cox proportional hazard regression analysis.
: Median patient age was 66 years with a mean follow-up of 42 months. Clinical stage distribution was Tis 8.9%, Ta 1.5%, T1 20.7%, T2 45.2%, T3 5.2%, and T4 5.2%. The five-year recurrence-free survival (RFS), disease-specific survival (DSS) and overall survival (OS) were 83%, 96%, and 88%, respectively. The 10-year RFS, DSS and OS were 66%, 92%, and 70%, respectively. On Cox proportional regression analysis, no variables were associated with disease recurrence and only patient age was associated with overall survival.
: Patients with pT0N0 pathology after cystectomy have excellent outcomes with high five- and 10-year RFS, DSS and OS. However, there is still a risk of tumour recurrence in this patient population and thus postoperative surveillance is still required.

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Keywords

42 months
 
clinical outcomes
 
Clinical stage distribution
 
Cox proportional hazard regression analysis
 
Cox proportional regression analysis
 
cystectomy
 
disease-specific survival
 
five-year recurrence-free survival
 
mean follow-up
 
Median patient age
 
muscle invasive bladder cancer
 
patient age
 
patient population
 
Patients
 
prognostic variables
 
pT0N0 bladder cancer
 
Radical cystectomy
 
standard treatment
 
Survival data
 
tumour recurrence