Academic Journal
Long-term Outcomes of Partial Cystectomy for Urothelial Carcinoma in the Era of Bladder Preservation.
| Τίτλος: | Long-term Outcomes of Partial Cystectomy for Urothelial Carcinoma in the Era of Bladder Preservation. |
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| Συγγραφείς: | Martin A; Department of Urology, Mayo Clinic, Rochester, MN., Shi C; Department of Urology, Mayo Clinic, Rochester, MN., Martinez GM; Department of Urology, Mayo Clinic, Rochester, MN., Britton C; Department of Urology, Mayo Clinic, Rochester, MN., Thapa P; Department of Health Sciences Research, Mayo Clinic, Rochester, MN., Khanna A; Department of Urology, Mayo Clinic, Rochester, MN., Boorjian SA; Department of Urology, Mayo Clinic, Rochester, MN., Tollefson MK; Department of Urology, Mayo Clinic, Rochester, MN., Shah P; Department of Urology, Mayo Clinic, Rochester, MN., Jeffrey Karnes R; Department of Urology, Mayo Clinic, Rochester, MN., Frank I; Department of Urology, Mayo Clinic, Rochester, MN., Sharma V; Department of Urology, Mayo Clinic, Rochester, MN. Electronic address: Sharma.Vidit@mayo.edu. |
| Πηγή: | Urology [Urology] 2026 Jul; Vol. 213, pp. 131-140. Date of Electronic Publication: 2026 Apr 15. |
| Τύπος έκδοσης: | Journal Article; Comparative Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Science Country of Publication: United States NLM ID: 0366151 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-9995 (Electronic) Linking ISSN: 00904295 NLM ISO Abbreviation: Urology Subsets: MEDLINE |
| Imprint Name(s): | Publication: New York : Elsevier Science Original Publication: Ridgewood, N.J., Professional Medical Services Co. |
| Ιατρικοί όροι (MeSH): | Cystectomy*/methods , Cystectomy*/adverse effects , Urinary Bladder Neoplasms*/surgery , Urinary Bladder Neoplasms*/mortality , Urinary Bladder Neoplasms*/pathology , Carcinoma, Transitional Cell*/surgery , Carcinoma, Transitional Cell*/mortality , Carcinoma, Transitional Cell*/pathology , Postoperative Complications*/epidemiology , Postoperative Complications*/etiology , Organ Sparing Treatments*/methods, Neoplasm Recurrence, Local/epidemiology ; Humans ; Male ; Female ; Aged ; Quality of Life ; Treatment Outcome ; Middle Aged ; Time Factors ; Patient Reported Outcome Measures ; Retrospective Studies |
| Περίληψη: | Objective: To compare perioperative complications, oncologic outcomes, and patient-reported outcomes between partial cystectomy (PC) and radical cystectomy (RC). Methods: We queried a prospectively maintained database to identify patients undergoing PC and RC for UCB between 1980-2020. Multivariable logistic regression compared 90-day major complications. Multivariable Cox regression examined oncologic outcomes. Quality of life (QoL), urinary symptoms, and decisional regret were assessed in survivors using validated survey instruments. Results: Among 277 PC patients and 3474 RC patients, PC was associated with fewer 90-day major complications (16.2% vs 33%, P < .01) and readmissions (5.8% vs 16.1%, P < .01) After PC, the 5-year intravesical recurrence risk was 40% and 5-year salvage cystectomy risk was 21%. PC did not compromise metastasis-free (HR 1.06, P = .59) or cancer-specific survival (HR 1.13, P = .21). Survey response rates were 43% (35/81) for PC and 18% (217/1176) for RC. QoL (P = .88) and decisional regret (P = .217) were similar between groups. PC patients had less financial difficulty (6% vs 24%, P = .01) and were less likely to feel less physically attractive (30% vs 51%, P = .04). Male PC patients reported less difficulty with erection (58% vs 87%, P < .001) and ejaculation (35% vs 78%, P < .001). Conclusion: Well-selected PC provides similar oncologic outcomes to RC with less perioperative morbidity and improved QoL. While intravesical recurrence and salvage cystectomy remain risks, guidelines should incorporate PC with adequate postoperative monitoring as an option for select patients with muscle-invasive UCB. (Copyright © 2026 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Stephen A Boorjian — consultant for Ferring and Johnson & Johnson. Vidit Sharma — owns personal stock <$10,000 in ImmunityBio and has served on their advisory board. The other authors have no conflict of interest to declare. |
| Entry Date(s): | Date Created: 20260416 Date Completed: 20260715 Latest Revision: 20260715 |
| Update Code: | 20260716 |
| DOI: | 10.1016/j.urology.2026.04.011 |
| PMID: | 41990886 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1527-9995 |
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| DOI: | 10.1016/j.urology.2026.04.011 |