title: Outcomes and prognostic factors of simple partial cystectomy for localized bladder urothelial cell carcinoma.
abstract: Radical cystectomy has remained the gold standard for recurrent superficial or muscle invasive bladder tumor. However, partial cystectomy still has a role in those who reject or have contraindications for radical cystectomy. In this study, we sought to identify predictors of bladder recurrence and overall survival after simple partial cystectomy. We included 27 patients with bladder tumor who received simple partial cystectomy without pelvic lymph node dissection between March 2000 and September 2013. Adjuvant chemotherapy or radiation therapy was prescribed according to the pathological results. Parameters were compared on the basis of bladder recurrence and overall survival. During a mean follow-up time of 39 months, five patients (18.5%) experienced bladder recurrence. An older age, a higher pathological stage, positive surgical margins, and distant metastases were significant predictors of overall survival (p = 0.031, p = 0.001, p = 0.001, and p = 0.011, respectively). Meanwhile, previous bladder instillation and positive surgical margins were significant predictors of bladder recurrence (p = 0.026 and p = 0.027, respectively). The rate of consecutive distant metastases (33.3%) was almost twice the rate of bladder recurrence (18.5%), and six patients developed consecutive distant metastases without first experiencing bladder recurrence. In patients who received a simple partial cystectomy as an alternative treatment, previous bladder instillation and positive surgical margins were significant predictors of bladder recurrence. Patients with an older age, positive surgical margins, and consecutive distant metastases had worse overall survival. Partial cystectomy with routine lymph node dissection may be a better option for achieving favorable long-term outcomes.
authors.affiliation: Division of Urology, Department of Surgery, Lotung Pohai Hospital, Yilan, Taiwan.
authors.forename: I-Hung
authors.initials: IH
authors.lastname: Shao
authors.affiliation: Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: changyinghsu@gmail.com.
authors.forename: Ying-Hsu
authors.initials: YH
authors.lastname: Chang
authors.affiliation: Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Kai-Jie
authors.initials: KJ
authors.lastname: Yu
authors.affiliation: Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Po-Hung
authors.initials: PH
authors.lastname: Lin
authors.affiliation: Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Liu
authors.affiliation: Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Cheng-Keng
authors.initials: CK
authors.lastname: Chuang
authors.affiliation: Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: See-Tong
authors.initials: ST
authors.lastname: Pang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery*; D019459:Urothelium / Q000473:pathology*
keywords: Bladder tumor; Partial cystectomy; Urothelial carcinoma