1. Oncologic outcomes and survival in pT0 tumors after radical cystectomy in patients without neoadjuvant chemotherapy: results from a large multicentre collaborative study
- Author
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Jean-Jacques Patard, Henry Botto, Evanguelos Xylinas, Jeremy Crew, Christian Pfister, Karim Bensalah, Vincent Flamand, Pascal Rischmann, Michel Soulié, François-Xavier Nouhaud, Benoit Peyronnet, Julien Casenave, François Iborra, François Rozet, Laurent Salomon, Stéphane Larré, Morgan Rouprêt, Stéphane Droupy, Hervé Wallerand, Sophie Ferlicot, Aurélie Paule Floch, Maryam Hitier, Yann Neuzillet, Laura Poissonnier, Pascale Grès, Luc Cormier, Jacques Irani, Jean-Nicolas Cornu, Xavier Durand, Sarah J. Drouin, Cyrille Bastide, Pierre Lunardi, Jérôme Rigaud, Denis Champetier, Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Department of Urology, Hôpital Foch [Suresnes], Service d'urologie, Hôtel-Dieu, Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service Urologie [Lapeyronie], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Service d'Urologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service d'Urologie - Transplantation Rénale - Andrologie, Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Hôpital La Milétrie, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Bladder Cancer Committee of the French National Association of Urology ('CC-AFU Vessie'), Service d'urologie et transplantation rénales [CHU Pitié-Salpêtrière], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Service d'urologie [Rennes], Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]
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Oncology ,Male ,medicine.medical_treatment ,030218 nuclear medicine & medical imaging ,0302 clinical medicine ,MESH: Aged, 80 and over ,Medicine ,Neoadjuvant therapy ,MESH: Aged ,Aged, 80 and over ,education.field_of_study ,030219 obstetrics & reproductive medicine ,MESH: Middle Aged ,MESH: Neoplasm Staging ,MESH: Follow-Up Studies ,Middle Aged ,Prognosis ,Neoadjuvant Therapy ,3. Good health ,MESH: Urinary Bladder Neoplasms ,Survival Rate ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Female ,MESH: Neoplasm Recurrence, Local ,Adult ,medicine.medical_specialty ,MESH: Survival Rate ,Urology ,Population ,MESH: Neoadjuvant Therapy ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Cystectomy ,MESH: Prognosis ,03 medical and health sciences ,Text mining ,Internal medicine ,Humans ,In patient ,education ,Survival rate ,Survival analysis ,Aged ,Neoplasm Staging ,Retrospective Studies ,MESH: Carcinoma, Transitional Cell ,Chemotherapy ,Carcinoma, Transitional Cell ,MESH: Humans ,Proportional hazards model ,business.industry ,MESH: Cystectomy ,Retrospective cohort study ,MESH: Adult ,MESH: Retrospective Studies ,MESH: Male ,Urinary Bladder Neoplasms ,Surgery ,Lymphadenectomy ,Neoplasm Recurrence, Local ,business ,MESH: Female ,Follow-Up Studies - Abstract
International audience; PURPOSE: To assess the postsurgical survival of patients with urothelial carcinoma of the bladder with pT0 tumor at pathologic examination of cystectomy specimens. METHODS: A multi-institutional, retrospective database was analyzed with data from 4758 radical cystectomy (RC) patients who underwent RC without neoadjuvant chemotherapy and who were diagnosed with pT0 on the basis of the pathologic specimen. Survival curves were estimated. A multivariate Cox model was used to evaluate the association between prognosis factors and disease recurrence or survival. RESULTS: Overall, 258 patients (5.4%) were included in the study. The median age was 64 years. At last resection, 171 tumors were invasive (at least pT2), and 87 were not. Median follow-up was 51 months. At multivariate analysis, initial location of the tumor and absence of lymphadenectomy were associated with tumor recurrence (P = 0.03 and P = 0.005, respectively) and specific mortality (P = 0.005 and 0.001, respectively). The main limitation of the study is its retrospective design, which is due to the rarity of this situation. Cancer-specific and recurrence-free survival rates were 89 and 85%, respectively, at 5 years and 82 and 80%, respectively, at 10 years. CONCLUSIONS: Despite acceptable oncological outcomes, patients with a pT0 tumor at the time of RC are still at risk of recurrence and progression and should not be considered to be entirely cured. In this population, stringent follow-up according to current recommendations should be effective.
- Published
- 2011
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