Partial rather than radical cystectomy for muscle-invasive bladder cancer does not compromise survival in appropriately selected patients, researchers reported here at the Canadian Urological Association annual meeting in St. John’s, Newfoundland.
In fact, in a study comparing 181 patients who underwent partial cystectomy and 3,139 who underwent radical cystectomy, Michael J. Leveridge, MD, of Queen’s University, Kingston, Ontario, and colleagues found that the partial cystectomy group had a significantly better 5-year cancer-specific survival rate than the radical cystectomy group (43% vs. 37%). The 5-year overall survival rates did not differ significantly (34% vs. 33%).
Additionally, the partial cystectomy group had a significantly shorter mean hospital length of stay (11.2 vs. 15.3 days) and a significantly lower 90-day re-admission rate (24% vs. 32%). Results showed no significant differences in 30-day or 90-day mortality.
The complexity, duration, and metabolic consequences of radical cystectomy, the authors noted in a poster presentation, may be especially difficult for many patients to withstand. Partial nephrectomy may reduce morbidity in selected patients. The classic indications for partial cystectomy include a solitary lesion away from the trigone, absence of carcinoma in situ, and adequate post-operative bladder capacity, the authors wrote.