Partial and radical cystectomy for bladder cancer in select patients offer the same metastasis-free and cancer-specific survival (CSS), data show.
Investigators at Mayo Clinic in Rochester, Minn., studied 86 bladder cancer patients who underwent partial nephrectomy and 167 who underwent radical cystectomy. Subjects were matched by age, gender, pathological T stage, and receipt of neoadjuvant chemotherapy.
The median follow-up was 6.2 years. The 10-year distant metastasis-free survival and CSS rates were 61% and 58% for the partial cystectomy patients, respectively, and 66% and 63%, respectively, for the radical cystectomy patients, according to findings published in The Journal of Urology (2012;188:1115-1119). The differences in outcomes between the groups were not statistically significant.
Four partial cystectomy patients (5%) showed extravesical pelvic tumor recurrence postoperatively compared with 29 radical cystectomy patients (17%), a significant difference between the groups. Thirty-three partial cystectomy patients (38%) were diagnosed with intravesical recurrence of tumor after surgery, and 16 (19%) initially treated with partial cystectomy eventually underwent radical cystectomy.
The investigators, led by Igor Frank, MD, concluded that although partial and radical cystectomy were associated with similar metastasis-free survival and CSS, “patients treated with partial cystectomy remain at risk for intravesical recurrence and, thus, they should be counseled and surveilled accordingly.”