title: Oncologic outcomes and survival in pT0 tumors after radical cystectomy in patients without neoadjuvant chemotherapy: results from a large multicentre collaborative study.
abstract: OBJECTIVE
  To assess the postsurgical survival of patients with urothelial carcinoma of the bladder with pT0 tumor at pathologic examination of cystectomy specimens.
  
  
  METHODS
  A multi-institutional, retrospective database was analyzed with data from 4758 radical cystectomy (RC) patients who underwent RC without neoadjuvant chemotherapy and who were diagnosed with pT0 on the basis of the pathologic specimen. Survival curves were estimated. A multivariate Cox model was used to evaluate the association between prognosis factors and disease recurrence or survival.
  
  
  RESULTS
  Overall, 258 patients (5.4%) were included in the study. The median age was 64 years. At last resection, 171 tumors were invasive (at least pT2), and 87 were not. Median follow-up was 51 months. At multivariate analysis, initial location of the tumor and absence of lymphadenectomy were associated with tumor recurrence (P = 0.03 and P = 0.005, respectively) and specific mortality (P = 0.005 and 0.001, respectively). The main limitation of the study is its retrospective design, which is due to the rarity of this situation. Cancer-specific and recurrence-free survival rates were 89 and 85%, respectively, at 5 years and 82 and 80%, respectively, at 10 years.
  
  
  CONCLUSIONS
  Despite acceptable oncological outcomes, patients with a pT0 tumor at the time of RC are still at risk of recurrence and progression and should not be considered to be entirely cured. In this population, stringent follow-up according to current recommendations should be effective.
authors.affiliation: Academic Department of Urology of la Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France. mroupret@gmail.com
authors.forename: Morgan
authors.initials: M
authors.lastname: Rouprêt
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Drouin
authors.forename: Stéphane
authors.initials: S
authors.lastname: Larré
authors.forename: Yann
authors.initials: Y
authors.lastname: Neuzillet
authors.forename: Henry
authors.initials: H
authors.lastname: Botto
authors.forename: Maryam
authors.initials: M
authors.lastname: Hitier
authors.forename: Jerome
authors.initials: J
authors.lastname: Rigaud
authors.forename: Jeremy
authors.initials: J
authors.lastname: Crew
authors.forename: Evanguelos
authors.initials: E
authors.lastname: Xylinas
authors.forename: Laurent
authors.initials: L
authors.lastname: Salomon
authors.forename: Jean-Nicolas
authors.initials: JN
authors.lastname: Cornu
authors.forename: François
authors.initials: F
authors.lastname: Iborra
authors.forename: Denis
authors.initials: D
authors.lastname: Champetier
authors.forename: François
authors.initials: F
authors.lastname: Rozet
authors.forename: Vincent
authors.initials: V
authors.lastname: Flamand
authors.forename: Cyrille
authors.initials: C
authors.lastname: Bastide
authors.forename: Luc
authors.initials: L
authors.lastname: Cormier
authors.forename: Xavier
authors.initials: X
authors.lastname: Durand
authors.forename: Pierre
authors.initials: P
authors.lastname: Lunardi
authors.forename: Pascal
authors.initials: P
authors.lastname: Rischmann
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Nouhaud
authors.forename: Sophie
authors.initials: S
authors.lastname: Ferlicot
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Patard
authors.forename: Aurélie Paule
authors.initials: AP
authors.lastname: Floch
authors.forename: Jacques
authors.initials: J
authors.lastname: Irani
authors.forename: Benoit
authors.initials: B
authors.lastname: Peyronnet
authors.forename: Karim
authors.initials: K
authors.lastname: Bensalah
authors.forename: Laura
authors.initials: L
authors.lastname: Poissonnier
authors.forename: Pascale
authors.initials: P
authors.lastname: Grès
authors.forename: Stéphane
authors.initials: S
authors.lastname: Droupy
authors.forename: Julien
authors.initials: J
authors.lastname: Casenave
authors.forename: Hervé
authors.initials: H
authors.lastname: Wallerand
authors.forename: Michel
authors.initials: M
authors.lastname: Soulié
authors.forename: Christian
authors.initials: C
authors.lastname: Pfister
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D015653:Cystectomy / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*