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The impact of completeness of last transurethral resection of bladder tumors on the outcomes of radical cystectomy.
- Source :
-
World Journal of Urology . Dec2019, Vol. 37 Issue 12, p2707-2714. 8p. - Publication Year :
- 2019
-
Abstract
- Purpose: To evaluate the role of a complete transurethral resection of bladder tumors (c-TURBT) on oncological outcomes after radical cystectomy (RC) and its relationship with adverse pathological features. Methods: We retrospectively analyzed data of 727 patients treated with RC and bilateral pelvic lymph node dissection at three tertiary referral centers. Possible c-TURBT was reported by the treating surgeon. Multivariable Cox regression analyses were used to assess the relationship of c-TURBT and survival outcomes after surgery in 1:1 propensity score-matched cohort adjusted for age and gender. Moreover, multivariable logistic regression (MVA) was built to predict the relationship between c-TURBT and pT3–T4 stages at RC, lymph node invasion (LNI) and positive soft tissue surgical margin (STSM). Results: A total of 433 (60%) patients received a c-TURBT. 3.0% of patients with a c-TURBT achieved a pT0–pTa–pTis status vs. 2.0% of patients with incomplete TURBT. At multivariable Cox regression analyses, c-TURBT was not associated with survival outcomes. At MVA, incompleteness of TURBT was significantly associated with a pT3–T4 stage [odds ratio (OR) 8.04, 95% confidence interval (CI) 2.33–27.67, p = 0.001]. No significant association was found between c-TURBT, LNI and STSM. Conclusion: We found a low rate of achievement of pT0 stage at RC. An incomplete TURBT before RC represented a predictor of pT3–T4 stages, but no effect of a c-TURBT was shown on survival outcomes. Given the current inadequacy of clinical staging strategies with more than 50% of extravesical disease being under-staged, our results could improve patients selection for NAC, driving the decision-making in doubtful cases. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 07244983
- Volume :
- 37
- Issue :
- 12
- Database :
- Academic Search Index
- Journal :
- World Journal of Urology
- Publication Type :
- Academic Journal
- Accession number :
- 139773410
- Full Text :
- https://doi.org/10.1007/s00345-019-02734-6