Purpose: To assess long-term functional and oncologic outcomes of prostate sparing cystectomy (PSC) as a sexuality-preserving alternative to radical cystectomy in a selected group of bladder cancer (BC) patients.
Materials And Methods: Between 1995 and 2014, 185 BC patients underwent PSC according to one of two standardized procedures at two centers. All patients had received extensive evaluation to rule out prostate cancer and BC at the bladder neck and prostatic urethra (PU), including prostate specific antigen blood analysis, transrectal ultrasound and/or prostate biopsies, PU biopsies and/or PU frozen section analysis. All patients received an orthotopic ileal neobladder. Overall survival (OS) was assessed by Kaplan-Meier estimates. Cumulative incidence of cancer specific mortality, any recurrence and loco-regional recurrence were calculated using competing-risk methods. Finally, functional outcomes (voiding, continence and erectile function) were evaluated.
Results: 185 patients (cTa-3N0M0) with a mean age of 57 years (SD: 9) were included. Median follow-up was 7.5 years (IQR: 5.6-10.8). Five-year OS was 71% and 5-year cumulative incidence of recurrence was 31%. Twenty patients (10.8%) had a loco-regional recurrence, two recurrences were in the PU. During follow-up, prostate cancer was detected in six patients (3.2%). Erectile function was preserved in 86.1% of patients, complete daytime and nighttime continence in 95.6% and 70.2%, respectively.
Conclusion: This two-center study shows that in men with BC in whom the prostate and PU were proven free of malignancy, PSC would represent a valid treatment option with excellent functional outcome. Oncologic outcomes were comparable to what is known from radical cystoprostatectomy series.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ejso.2018.05.032 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Development and validation of nomograms for predicting pentafecta outcomes before and after robot-assisted radical prostatectomy: a retrospective study.
Sci Rep
January 2025
Department of Urology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
Prostate cancer (PCa) is one of the most common cancers among men worldwide, and robot-assisted radical prostatectomy (RARP) is a widely used treatment for localized PCa. Achieving pentafecta outcomes, which include continence, potency, cancer control, free surgical margins, and no major complications, is a critical measure of surgical success and long-term prognosis. However, predicting these outcomes remains challenging.
View Article and Find Full Text PDFRelationship Between Radiation Therapy and Fecal Incontinence in Patients Treated for Localized Prostate Cancer: Results of the French ICONES Study.
Prostate
January 2025
AP-HP. Department of Urology, Henri Mondor University Hospital, Creteil, France.
Background: Radiation-induced late fecal incontinence (LFI) is one of the most quality-of-life impairing symptoms in prostate cancer. We aimed to assess the impact of radiotherapy (RT) technique and dose-volume effects on LFI using a robust score.
Methods: We identified 409 patients who underwent curative intent using standard fractionated radiation therapy, 190 of them were finally included and analyzed.
Ultrasound-guided Transperineal Prostate Thermal Ablation (TPTA) for Benign Prostatic Hyperplasia: Feasibility of an Outpatient Procedure using Radiofrequency Ablation.
Cardiovasc Intervent Radiol
January 2025
Department of Radiology, Universidade Federal de São Paulo (UNIFESP), Rua Dr. Ovidio Pires de Campos, 75, Cerqueira César, São Paulo, SP, 05403-010, Brazil.
Purpose: To evaluate the feasibility, safety, and short-term (3-month) results of transperineal prostate thermal ablation (TPTA) as a minimally invasive outpatient treatment for benign prostatic hyperplasia (BPH).
Materials And Methods: A prospective nonrandomized study of 25 patients with lower urinary tract symptoms secondary to BPH seeking care at 2 interventional radiology centers between March and July 2024. TPTA was performed using a 17G radiofrequency needle with a 10-mm active tip under unconscious sedation combined with bilateral perineal and periprostatic nerve blocks.
Long-term Outcomes of Prostate Capsule-Sparing and Nerve-Sparing Radical Cystectomy With Neobladder: A Propensity Score-Matched Comparison.
Int Neurourol J
December 2024
Department of Urology, Jinhua Hospital Affiliated to Zhejiang University School of Medicine, Jinhua, China.
Purpose: This study aimed to compare and analyze the feasibility and long-term efficacy of prostatic capsule-sparing (PCS) and nerve-sparing (NS) radical cystectomy in the treatment of bladder cancer.
Methods: From June 2004 to December 2021, our institution treated and followed 145 patients who underwent radical cystectomy with neobladder reconstruction for over a year. These patients were divided into 2 groups: PCS (n=74) and NS (n=71).
Prostate MRI and clinicopathologic risk calculator to predict laterality of extraprostatic extension at radical prostatectomy.
Prostate Cancer Prostatic Dis
January 2025
Northwestern University, Feinberg School of Medicine, Department of Urology, Chicago, IL, 60611, USA.
Background: Traditional nomograms can inform the presence of extraprostatic extension (EPE) but not laterality, which remains important for surgical planning, and have not fully incorporated multiparametric MRI data. We evaluated predictors of side-specific EPE on surgical pathology including MRI characteristics and developed side-specific EPE risk calculators.
Methods: This was a retrospective cohort of patients evaluated with mpMRI prior to radical prostatectomy (RP) in our eleven hospital healthcare system from July 2018-November 2022.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!