title: Outcome of metastasectomy for urothelial carcinoma: a multi-institutional retrospective study in Japan.
abstract: OBJECTIVE
  We determined prognostic factors associated with prolonged survival after metastasectomy for urothelial carcinoma.
  
  
  METHODS
  A total of 42 patients who underwent resection of urothelial carcinoma metastases with curative intent at 4 Japanese university hospitals were included in analysis. Of the patients 41 of 42 underwent systemic chemotherapy before and/or after metastasectomy. Overall survival was analyzed using the Kaplan-Meier method. The relationship between clinical characteristics and survival was analyzed using the log rank test.
  
  
  RESULTS
  Metastasectomy included lymph node dissection in 20 cases, pulmonary resection in 12, pelvic exenteration in 3, resection of local recurrence in 2, resection of subcutaneous metastasis in 2, liver resection in 1 and other in 2. Median overall survival was 29 months (IQR 19-80) from the initiation of treatment for metastases and 26 months (IQR 11-90) from metastasectomy. The overall 5-year survival rate after metastasectomy was 31%. On univariate analysis patients treated with metastasectomy for a solitary lung or solitary lymph node metastasis had significantly longer survival than the others who underwent metastasectomy (81 vs 19 months, log rank test p = 0.0296).
  
  
  CONCLUSIONS
  Long-term cancer control could be achieved in a subgroup of patients who undergo metastasectomy, especially those with a solitary lung or solitary lymph node metastasis.
authors.affiliation: Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. Electronic address: takataka@rf6.so-net.ne.jp.
authors.forename: Takashige
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Urology, Sapporo Medical University, Sapporo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kitamura
authors.affiliation: Department of Urology, Iwate Medical University, Iwate, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Obara
authors.affiliation: Department of Urology, Wakayama Medical University, Wakayama, Japan.
authors.forename: Nagahide
authors.initials: N
authors.lastname: Matsumura
authors.affiliation: Department of Urology, Sapporo Medical University, Sapporo, Japan.
authors.forename: Taiji
authors.initials: T
authors.lastname: Tsukamoto
authors.affiliation: Department of Urology, Iwate Medical University, Iwate, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Fujioka
authors.affiliation: Department of Urology, Wakayama Medical University, Wakayama, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Hara
authors.affiliation: Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Murai
authors.affiliation: Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Shinohara
authors.affiliation: Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Nonomura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D007564:Japan; D008207:Lymphatic Metastasis; D008297:Male; D059146:Metastasectomy; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014571:Urologic Neoplasms / Q000473:pathology*
keywords: carcinoma; lymph nodes; neoplasm metastasis; urinary bladder; urothelium