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• W2078598893 abstract "You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-based Medicine & Outcomes I1 Apr 2015MP5-02 PARTIAL CYSTECTOMY FOR UROTHELIAL CARCINOMA OF THE BLADDER: PRACTICE PATTERNS AND OUTCOMES IN THE GENERAL POPULATION Michael Leveridge, D Robert Siemens, Jason Izard, Xuejiao Wei, William Mackillop, David Berman, and Christopher Booth Michael LeveridgeMichael Leveridge More articles by this author , D Robert SiemensD Robert Siemens More articles by this author , Jason IzardJason Izard More articles by this author , Xuejiao WeiXuejiao Wei More articles by this author , William MackillopWilliam Mackillop More articles by this author , David BermanDavid Berman More articles by this author , and Christopher BoothChristopher Booth More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.229AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urothelial carcinoma of the bladder (UCB) is a disease that commonly affects elderly patients and those with other co-morbidities. Partial cystectomy (PC) for highly selected tumors and patients may avoid the high morbidity of radical cystectomy (RC) and urinary diversion. We sought to assess the practice patterns and outcomes of PC for UCB in routine clinical practice. METHODS All patients with UCB undergoing PC or RC in Ontario from 1994–2008 were identified using the Ontario Cancer Registry. Pathology reports were reviewed. Treatment and survival data were linked to the study database. Variables associated with use of PC were identified using logistic regression. Cox proportional hazards model was used to identify factors associated with survival among patients treated with PC. RESULTS We identified 3320 patients who underwent PC (n=181; 5.5%) or RC (n=3139; 94.5%) in the study period. 36% of PC patients were >80 years old, vs 19% of RC patients (p<0.001). More PC patients had organ-confined (<pT3) disease (54% PCvs 36% RC; p<0.001). Two thirds (67%) of PC patients did not undergo lymph node dissection at the time of surgery (24% for RC; p<0.001). Surgical margins were positive in 33 patients (18%) at PC, and 21 patients (12%) received adjuvant chemotherapy (ACT). Surgery early in the study period, age ≥70, Charlson comorbidity score ≥3 and surgery outside of a regional cancer center were associated with higher use of PC. Unadjusted five-year overall survival (OS) for PC and RC cases was 34% and 33% respectively (p=0.455); cancer-specific survival was 43% (PC) and 37% (RC) (p=0.045). On multivariate analysis of PC cases, pT3+ disease (HR 1.49 [1.02-2.19]) and node-positive disease (HR 3.45 [1.80-2.46]) were independently predictive of OS, while pT3+ (HR 2.59 [1.70-3.94]), node-positive disease (HR 3.89 [1.83-8.27]) and LVI (HR 2.82 [1.51-5.26]) predicted CSS. CONCLUSIONS In the population setting, use of PC is not common and is used more often in elderly patients. Two-thirds of patients treated with PC do not undergo lymphadenectomy. A substantial proportion of patients treated with PC achieve long-term survival. PC remains a treatment option in selected patients with UCB. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e45 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Leveridge More articles by this author D Robert Siemens More articles by this author Jason Izard More articles by this author Xuejiao Wei More articles by this author William Mackillop More articles by this author David Berman More articles by this author Christopher Booth More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2078598893 title "MP5-02 PARTIAL CYSTECTOMY FOR UROTHELIAL CARCINOMA OF THE BLADDER: PRACTICE PATTERNS AND OUTCOMES IN THE GENERAL POPULATION" @default.
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