title: Clinicopathological features of recurrence after radical cystectomy for patients with transitional cell carcinoma of the bladder.
abstract: BACKGROUND
  The objective of this study was to investigate the clinicopathological features of recurrent transitional cell carcinoma (TCC) of the bladder in patients who had previously undergone radical cystectomy.
  
  
  METHODS
  This study included 124 patients who underwent radical cystectomy for transitional cell carcinoma (TCC) of the bladder in our institution. Several clinicopathological factors were analyzed to characterize differences between patients with and without disease recurrence, and determined predictive factors for disease recurrence using multivariate analysis. We further analyzed prognostic parameters that affect survival after disease recurrence was diagnosed.
  
  
  RESULTS
  Of the 124 patients, 24 (19.5%) developed recurrence, and the median time to recurrence was 9.5 months (range, 1-44 months). The 5-year recurrence-free survival in these 124 patients was 75.6%. The incidence of disease recurrence was significantly associated with gender, pathological stage, lymph node metastasis, lymphatic invasion and blood vessel invasion. Multivariate analysis identified gender, pathological stage and lymph node metastasis as independent predictors of disease recurrence following radical cystectomy. After disease recurrence, the 1-year cancer-specific survival of the 24 patients was 16.7%; that is, 23 of the 24 patients had died of progressive recurrent diseases, while the remaining 1 who survived had developed recurrence in the upper urinary tract.
  
  
  CONCLUSIONS
  These findings suggest that careful follow-up should be performed after radical cystectomy for TCC of the bladder considering gender, pathological stage and nodal involvement; however, once recurrent disease develops, the prognosis of such patients is extremely poor. Therefore, it would be potentially important to establish a multimodal therapeutic approach targeting recurrent TCC of the bladder.
authors.affiliation: Department of Urology, Hyogo Medical Center for Adults, Akashi, Japan.
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Harada
authors.forename: Iori
authors.initials: I
authors.lastname: Sakai
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Kurahashi
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Muramaki
authors.forename: Kazuki
authors.initials: K
authors.lastname: Yamanaka
authors.forename: Isao
authors.initials: I
authors.lastname: Hara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Eto
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyake
mesh_terms: D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D015653:Cystectomy; D005260:Female; D006801:Humans; D008297:Male; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*