Prostate-sparing cystectomy: long-term oncological results.
OBJECTIVE
To analyse the oncological outcome of prostate-sparing cystectomy (PSC).


METHODS
Between 1994 and 2006, 63 men were treated with PSC after meeting the inclusion criteria (no tumour at the bladder neck, no prostate cancer). The results were compared with patients who had a standard cystoprostatectomy (SC) during the same study period, after matching for clinical and pathological characteristics.


RESULTS
The 3- and 5-year disease-specific survival rates were 77% and 66% in the PSC group, and 68% and 64% in the SC group (log-rank, P = 0.6). The local recurrence rate was 7.9% and 16% for the PSC and the SC groups, respectively, and the respective distant recurrence rate was 29% and 33%. Subsequent prostate cancer was detected in 3% in the PSC group. None of these patients died from prostate cancer. In the SC group the final pathology showed that 18% had prostate cancer.


CONCLUSIONS
Local recurrences were not diagnosed more often in the PSC than the SC group. The outcomes of both procedures are comparable with contemporary cystoprostatectomy series. We consider this procedure oncologically safe and offer this to selected patients. However, selection is the key to success, and our results should further be corroborated by the experience of others.
de Vries
Remco R
RR
Departments of Urology, the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amstedam, the Netherlands.
Nieuwenhuijzen
Jakko A
JA
van Tinteren
Harm
H
Oddens
Jorg R
JR
Visser
Otto
O
van der Poel
Henk G
HG
Bex
Axel
A
Meinhardt
Willem
W
Horenblas
Simon
S
D015653:Cystectomy / Q000379:methods*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000209:etiology* / Q000401:mortality; D011467:Prostate; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods