Oncologic, perioperative outcomes of female radical cystectomy: Results from a multicenter study in Korea

Ji Sung Shim, Ho Kyung Seo, Ja Hyeon Ku, Byong Chang Jeong, Bumsik Hong, Seok Ho Kang

Research output: Contribution to journalArticle

Abstract

Purpose The lower incidence of bladder cancer among women has led to a lack of information on female radical cystectomy (RC). This study aimed to analyze the characteristics related with female RC in a cohort from multiple academic institutions. Materials and Methods This was a retrospective review of 384 female patients who underwent RC for bladder cancer. Epidemiologic, perioperative variables including urologic referral period with consequent pathologic stage distributions were assessed. The changes in surgical techniques over time were illustrated. Also, we evaluated recurrence-free survival (RFS) at 2 and 5 years and overall survival (OS) at 5 years with stage-specific analyses using the Kaplan-Meier method. Results The mean follow-up time was 35 months (interquartile rage [IQR], 9 to 55). The average time to urologic referral with initial symptoms was 5.5 (IQR, 1 to 6) months and over 20% of patients visited clinics after 6 months. In subsequent stage distributions according to referral period, T2 or higher stage distributions were abruptly increased after 1 year. Overall 2-year/5-year RFS rates were 0.72/0.57 and 5-year OS was 0.61. Notable surgical descriptions were as follows: 91% of patients underwent open RC; 80% of patients underwent an ileal conduit; and 83% of patients received anterior exenteration. However, the proportions of robotic surgery, orthotopic neobladder and organ sparing cystectomy have increased recently. Conclusion We identified the general characteristics and changes in pattern of female RC. Our results also suggest that women are susceptible to delays in referral to an urologist and are at greater risk for worse prognosis.

Original languageEnglish
Pages (from-to)1064-1072
Number of pages9
JournalCancer Research and Treatment
Volume51
Issue number3
DOIs
Publication statusPublished - 2019 Jul 1

Fingerprint

Cystectomy
Korea
Multicenter Studies
Referral and Consultation
Rage
Urinary Bladder Neoplasms
Survival
Recurrence
Urinary Diversion
Kaplan-Meier Estimate
Robotics
Survival Rate
Incidence

Keywords

  • Cystectomy
  • Female
  • Urinary bladder neoplasms

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Oncologic, perioperative outcomes of female radical cystectomy : Results from a multicenter study in Korea. / Shim, Ji Sung; Seo, Ho Kyung; Ku, Ja Hyeon; Jeong, Byong Chang; Hong, Bumsik; Kang, Seok Ho.

In: Cancer Research and Treatment, Vol. 51, No. 3, 01.07.2019, p. 1064-1072.

Research output: Contribution to journalArticle

Shim, Ji Sung ; Seo, Ho Kyung ; Ku, Ja Hyeon ; Jeong, Byong Chang ; Hong, Bumsik ; Kang, Seok Ho. / Oncologic, perioperative outcomes of female radical cystectomy : Results from a multicenter study in Korea. In: Cancer Research and Treatment. 2019 ; Vol. 51, No. 3. pp. 1064-1072.
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abstract = "Purpose The lower incidence of bladder cancer among women has led to a lack of information on female radical cystectomy (RC). This study aimed to analyze the characteristics related with female RC in a cohort from multiple academic institutions. Materials and Methods This was a retrospective review of 384 female patients who underwent RC for bladder cancer. Epidemiologic, perioperative variables including urologic referral period with consequent pathologic stage distributions were assessed. The changes in surgical techniques over time were illustrated. Also, we evaluated recurrence-free survival (RFS) at 2 and 5 years and overall survival (OS) at 5 years with stage-specific analyses using the Kaplan-Meier method. Results The mean follow-up time was 35 months (interquartile rage [IQR], 9 to 55). The average time to urologic referral with initial symptoms was 5.5 (IQR, 1 to 6) months and over 20{\%} of patients visited clinics after 6 months. In subsequent stage distributions according to referral period, T2 or higher stage distributions were abruptly increased after 1 year. Overall 2-year/5-year RFS rates were 0.72/0.57 and 5-year OS was 0.61. Notable surgical descriptions were as follows: 91{\%} of patients underwent open RC; 80{\%} of patients underwent an ileal conduit; and 83{\%} of patients received anterior exenteration. However, the proportions of robotic surgery, orthotopic neobladder and organ sparing cystectomy have increased recently. Conclusion We identified the general characteristics and changes in pattern of female RC. Our results also suggest that women are susceptible to delays in referral to an urologist and are at greater risk for worse prognosis.",
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