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• W2023389707 abstract "Apresentar a nossa experiência clínica e cirúrgica da cistectomia radical no carcinoma da bexiga, avaliar as complicações pós-operatórias e a sobrevida global dos doentes. Foi efectuada uma análise retrospectiva de todos os doentes submetidos a cistectomia radical por carcinoma da bexiga entre 2006 e 2010. As características patológicas foram descritas com base na classificação TNM de 2009. Foram avaliadas as complicações pós-operatórias nos primeiros 30 dias após a cirurgia, segundo a escala de Clavien-Dindo e calculada a sobrevida global. Foram analisados os dados de 195 doentes com uma idade média de 67,8 anos (28–87 anos). 82,6% eram do sexo masculino. A mediana do tempo de seguimento foi de 2,5 anos. Foi diagnosticado carcinoma urotelial em 93,8% dos casos. A maioria dos doentes apresentava doença extravesical, com estádio patológico T3 em 28,7% e T4 em 22,1%. Em 32,8% dos doentes submetidos a linfadenectomia foram detectadas metástases ganglionares. A derivação urinária mais frequente foi a uretero-ileostomia cutânea realizada em 79% dos casos, seguida pela neobexiga em 10,3%. Foram registadas complicações pós-operatórias em 40,5% dos doentes, sendo 28,2% grau I/II e 12,3% grau III-V, com uma taxa de mortalidade de 3,6%. A sobrevida global aos 3 anos foi de 54% e aos 5 anos foi de 48%. Os casos com doença localizada à bexiga (≤ pT2N0) apresentaram uma sobrevida aos 3 anos de 89%. A presença de doença extravesical (≥ pT3) e a metastização ganglionar confirmaram ser factores de mau prognóstico, com sobrevidas globais aos 3 anos de 46% e de 22%, respectivamente. Os resultados desta série mostram que a cistectomia radical é uma cirurgia complexa mas com morbilidade e mortalidade pós-operatória precoce razoáveis. A cirurgia deve ser efectuada numa fase inicial da doença de forma a oferecer os melhores resultados de sobrevida. To present our clinical and surgical experience of radical cystectomy in bladder cancer, evaluate postoperative complications and overall survival. We performed a retrospective analysis of all patients undergoing radical cystectomy for bladder cancer between 2006 and 2010. Pathological characteristics were described based on 2009 TNM classification. We evaluated postoperative complications in the first 30 days after surgery according to the Clavien-Dindo classification and determined overall survival. We analyzed the data from 195 patients with a mean age of 67.8 years (28-87 years). 82.6% were male. The median follow-up was 2.5 years. Urothelial cancer was diagnosed in 93.8% cases. The majority of patients had extravesical disease with pathologic T3 stage in 28.7% and T4 in 22.1%. 32.8% of patients who underwent lymphadenectomy had positive lymph nodes. The most frequent urinary diversion was the ileal conduit, performed in 79% of cases, followed by neobladder in 10.3%. Postoperative complications were reported in 40.5% of patients, 28.2% were grade I/II and 12.3% were grade III-V, with a mortality rate of 3.6%. The overall survival at 3 years was 54% and at 5 years was 48%. The cases with disease localized to the bladder (≤ pT2N0) showed a 3-year survival of 89%. The presence of extravesical disease (≥ pT3) and lymph nodes metastasis confirmed to be poor prognostic factors, with a 3-year overall survival of 46% and 22%, respectively. This series results show that radical cystectomy is a complex surgery but with reasonable early postoperative morbidity and mortality. Surgery should be performed in the early stages of disease in order to offer the best survival outcomes." @default.
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• W2023389707 date "2014-12-01" @default.
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• W2023389707 title "Cistectomia radical / experiência de um centro oncológico" @default.
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