Urinary Diversion: Bladder Reconstruction, Augmentation, Substitution, Diversion (II)Podium Session 251418 THE RISK OF TUMOR-RELATED COMPLICATIONS IN PATIENTS WITH ILEAL-NEOBLADDERS
Section snippets
INTRODUCTION AND OBJECTIVES
Radical cystectomy is a standard therapy for invasive bladder cancer. The choice of urinary diversion is often affected by the surgeons' fear of tumor complications. Since an ileal neobladder is the form of urinary diversion that is located exactly at the former tumor site, it is important to evaluate the real extent of this risk in a neobladder population.
METHODS
This study is based on the cystectomy series of the University of Ulm 01/86 - 12/08 and of the Kassel General Hospital 01/00 - 12/08. We included all patients with a cystectomy performed for urothelial bladder cancer. The tumor stage was non-organ confined (at least pT3a), or lymph-node positive or metastatic (M1). We excluded those cases with age > 75y and those with macroscopic residual tumor in the true pelvis (R2). We obtained a complete follow-up until 12/08. The mean follow-up was 35
RESULTS
We included 540 patients (Ulm: 471, Kassel: 69). The 5- and 10-year overall survival was 27.6% and 16.2%, respectively. 284 patients had an ileal neobladder (NBL), 256 other forms of urinary diversion (OTH). The rates of lymph-node metastases and distant metastases were: NBL: 63% and 6%, OTH: 56% and 13%. After 10 years the overall survival was better in the NBL group for pT3b-4b pN0/1 tumors (28.6% vs. 17.6%) and for pN2-3 or M1 tumors (8.0% vs. 3.7%).The rate of local recurrence was 17.3% in
CONCLUSIONS
Patients with ileal neobladders were younger, had a lower comorbidity and better tumor stages than patients with other forms of urinary diversion. The risk of tumor-related neobladder complications remained low and could be handled with preservation of the neobladder in almost all cases. Ileal neobladders can be safely offered to patients even with advanced tumor stages, as long as there is no residual tumor visible in the true pelvis at the end of cystectomy.
References (0)
Cited by (0)
Source of Funding: None