INTRODUCTION AND OBJECTIVES: The recurrence of urothelial cancer after radical cystectomy (RC) for bladder cancer (BCa) associates with a reduced survival during follow up. However, data about different patterns of recurrence is limited in literature and the impact of the site of the first recurrence on cancer specific mortality (CSM) still remains to be defined. METHODS: The study included 1,250 consecutive BCa patients treated with RC at a single tertiary care institution between January 1990 and August 2013. All with recurrence information available. Complete clinical, pathological and follow-up data were available for all the patients. Moreover, status, timing as well as site of first recurrence were available for all patients. Kaplan-Meier curves assessed the time to recurrence and time to survival after first recurrence. Logistic regression analyses were performed in order to assess characteristics related to dead within 3 months and beyond 12 months after first recurrence. RESULTS: With a mean follow up of 106 months (median: 88), recurrence were recorded for 416 patients (33.2%). Of these, 11 patients experienced brain recurrence (2.6%), 63 liver recurrence (15.1%), 61 nodes recurrence (14.7%), 66 bone recurrence (15.9%), 30 pelvic recurrence (7.2%), 19 peritoneal recurrence (4.6%), 81 lung recurrence (19.5%), 16 ureter recurrence (3.8%), 17 urethral recurrence (4.1%) and 52 (12.5%) patients have unknown site of recurrence. The mean survival after recurrence was 10 months (median, IQR). Specifically brain recurrence has aCSMat 3, 6 and 12months of 45, 36 and 9%, liver of 74, 53 and 32%, lung of 70, 59 and 34%, bone 82, 51, and 23%, pelvic of 78, 33 and 12%, nodal of 93, 76 and 48%, peritoneal 47%, 27% and 9%, ureteral 92, 83, 72% and urethral 100, 91 and 51%. Patients with peritoneal or brain recurrence had the highest rate of death within 3 months after recurrence (p¼0.02 and 0.04 respectively vs. others recurrence).Conversely, patients with nodal and ureteral recurrence had the highest chance of surviving for 12 or more months (p¼0.01 and 0.004 respectively vs. others recurrence). CONCLUSIONS: According to the results of our monocentric series different time to BCa-specific mortality should be expected according to the site of first disease recurrence after RC. This information might be helpful to physicians in order to adopt different therapeutic and palliative strategies for patients according to the site of recurrence.
Moschini, M., Suardi, N., Bianchi, M., Cucchiara, V., Luzzago, S., D'Amato, F., et al. (2015). IMPACT OF THE SITE OF RECURRENCE AFTER RADICAL CYSTECTOMY ON SURVIVAL: DIFFERENT SITES FOR DIFFERENT OUTCOMES. In Abstracts of the 110th Annual Meeting of the American Urological Association (pp.e922-e922).
|Autori:||Moschini, M.; Suardi, N.; Bianchi, M.; Cucchiara, V.; Luzzago, S.; D'Amato, F.; Serretta, V.; Briganti, A.; Shariat, S.; Damiano, R.; Karnes, J.; Montorsi, F.; Colombo, R.|
|Titolo:||IMPACT OF THE SITE OF RECURRENCE AFTER RADICAL CYSTECTOMY ON SURVIVAL: DIFFERENT SITES FOR DIFFERENT OUTCOMES|
|Data di creazione:||2015-05-18|
|Nome del convegno:||Annual Meeting of the American-Urological-Association (AUA)|
|Luogo del convegno:||New Orleans USA|
|Anno del convegno:||MAY 15-19, 2015|
|Numero del convegno:||110th|
|Data di pubblicazione:||2015|
|Numero di pagine:||1|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.juro.2015.02.2638|
|Citazione:||Moschini, M., Suardi, N., Bianchi, M., Cucchiara, V., Luzzago, S., D'Amato, F., et al. (2015). IMPACT OF THE SITE OF RECURRENCE AFTER RADICAL CYSTECTOMY ON SURVIVAL: DIFFERENT SITES FOR DIFFERENT OUTCOMES. In Abstracts of the 110th Annual Meeting of the American Urological Association (pp.e922-e922).|
|Tipologia:||0 - Proceedings (TIPOLOGIA NON ATTIVA)|
|Appare nelle tipologie:||0 - Proceedings (TIPOLOGIA NON ATTIVA)|