title: Urethral recurrence following neobladder in bladder cancer patients.
abstract: Risk factors of urethral recurrence after neobladder in bladder cancer patients were studied. Between 1977 and 2001, 73 patients (male 58, female 15) underwent neobladder as a treatment for bladder cancer. The observation time after cystectomy ranged from 2 to 254 months (median 60.5). Ten (17.2%) of 58 male patients had urethral recurrence and of the 10, 8 patients had multiple bladder cancers including bladder neck. Urethral recurrence was found by macrohematuria, follow-up cystourethroscopy, and inguinal lymph node swelling. Only one who complained of macrohematuria had positive urinary cytology. Of 58 male patients, 5 underwent total nephroureterectomy for renal pelvic or ureteral cancer before radical cystectomy, and 3 of the 5 had urethral recurrence. Two of 10 patients with urethral recurrence died with cancer, and they had renal pelvic or ureteral cancer. The five-year cause specific survival was 83% for patients with urethral recurrence, and 79% for those without urethral recurrence, respectively. Urethral recurrence did not have a significant effect on survival. The patients with multiple bladder cancers including bladder neck, and renal pelvic or ureteral cancer before radical cystectomy, have high risks for urethral recurrence. Urinary cytology has limited value for the detection of urethral recurrence.
authors.affiliation: Department of Urology, Tohoku University School of Medicine, Sendai 980-8574.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Yamashita
authors.forename: Senji
authors.initials: S
authors.lastname: Hoshi
authors.forename: Chikara
authors.initials: C
authors.lastname: Ohyama
authors.forename: Makoto
authors.initials: M
authors.lastname: Satoh
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Soma
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Okada
authors.forename: Shinnosuke
authors.initials: S
authors.lastname: Kato
authors.forename: Ichiro
authors.initials: I
authors.lastname: Shintaku
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Arai
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D003131:Combined Modality Therapy; D015653:Cystectomy; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D012307:Risk Factors; D013534:Survival; D014057:Tomography, X-Ray Computed; D014523:Urethral Neoplasms / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*