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pT3 Substaging is a Prognostic Indicator for Lymph Node Negative Urothelial Carcinoma of the Bladder

2010; Lippincott Williams & Wilkins; Volume: 184; Issue: 2 Linguagem: Inglês

10.1016/j.juro.2010.04.007

1527-3792

Derya Tilki, Robert S. Svatek, Pierre I. Karakiewicz, Giacomo Novara, Michael Seitz, Guru Sonpavde, Amit Gupta, Wassim Kassouf, Yves Fradet, Vincenzo Ficarra, Eila C. Skinner, Yair Lotan, Arthur I. Sagalowsky, Christian G. Stief, Oliver Reich, Shahrokh F. Shariat,

Esophageal Cancer Research and Treatment

No AccessJournal of UrologyAdult Urology1 Aug 2010pT3 Substaging is a Prognostic Indicator for Lymph Node Negative Urothelial Carcinoma of the Bladder Derya Tilki, Robert S. Svatek, Pierre I. Karakiewicz, Giacomo Novara, Michael Seitz, Guru Sonpavde, Amit Gupta, Wassim Kassouf, Yves Fradet, Vincenzo Ficarra, Eila Skinner, Yair Lotan, Arthur I. Sagalowsky, Christian G. Stief, Oliver Reich, and Shahrokh F. Shariat Derya TilkiDerya Tilki Department of Urology, Ludwig-Maximilians-University, Klinikum Grosshadern, Munich, Germany , Robert S. SvatekRobert S. Svatek University of Texas Southwestern Medical Center, Dallas, Texas , Pierre I. KarakiewiczPierre I. Karakiewicz University of Montréal, Montréal, Québec, Canada , Giacomo NovaraGiacomo Novara University of Padua, Padua, Italy , Michael SeitzMichael Seitz Department of Urology, Ludwig-Maximilians-University, Klinikum Grosshadern, Munich, Germany , Guru SonpavdeGuru Sonpavde Baylor College of Medicine, Houston, Texas , Amit GuptaAmit Gupta University of Texas Southwestern Medical Center, Dallas, Texas , Wassim KassoufWassim Kassouf McGill University Health Centre, Montréal, Québec, Canada , Yves FradetYves Fradet Laval University, Québec City, Québec, Canada , Vincenzo FicarraVincenzo Ficarra University of Padua, Padua, Italy , Eila SkinnerEila Skinner University of Southern California, Los Angeles, California , Yair LotanYair Lotan University of Texas Southwestern Medical Center, Dallas, Texas , Arthur I. SagalowskyArthur I. Sagalowsky University of Texas Southwestern Medical Center, Dallas, Texas , Christian G. StiefChristian G. Stief Department of Urology, Ludwig-Maximilians-University, Klinikum Grosshadern, Munich, Germany , Oliver ReichOliver Reich Department of Urology, Ludwig-Maximilians-University, Klinikum Grosshadern, Munich, Germany , and Shahrokh F. ShariatShahrokh F. Shariat Weill Medical College of Cornell University, New York, New York View All Author Informationhttps://doi.org/10.1016/j.juro.2010.04.007AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assessed the prognostic value of pT3 bladder urothelial carcinoma substaging. Materials and Methods: We reviewed the records of 2,605 patients treated with radical cystectomy for bladder urothelial carcinoma at 6 international centers, of whom 808 (31.0%) had pT3 disease. No patient received systemic chemotherapy or radiotherapy preoperatively. Median followup was 45 months in survivors at last followup. Results: Median patient age was 68 years. Stage was pT3a in 310 patients (38.4%) and pT3b in 498 (61.6%). Of the patients 352 (43.6%) had metastasis to regional lymph nodes. Five-year recurrence-free (43.8% and 41.4%) and cancer specific (48.6% and 46.8%) survival estimates were similar in pT3a and pT3b cases (p = 0.277 and 0.625, respectively). Conversely in patients with pathologically negative lymph nodes pT3b substaging was associated with worse 5-year recurrence-free (60.7% vs 47.9%) and cancer specific (64.4% vs 55.0%) survival (p = 0.020 vs 0.048). Conclusions: Macroscopic perivesical fat extension (pT3b) is associated with a worse outcome than pT3a disease in lymph node negative cases of bladder urothelial carcinoma. Together with other features pT3 substaging may help identify patients with pT3 who could benefit from adjuvant chemotherapy. References 1 : AJCC Cancer Staging Manual. In: . Philadelphia: Lippincott-Raven1997: 241. 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Link, Google Scholar © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byMay M, Bastian P, Brookman-May S, Fritsche H, Bolenz C, Gilfrich C, Otto W, Trojan L, Herrmann E, Müller S, Ellinger J, Buchner A, Stief C, Tilki D, Wieland W, Hohenfellner M, Haferkamp A, Roigas J, Zacharias M, Nuhn P and Burger M (2012) External Validation of a Risk Model to Predict Recurrence-Free Survival After Radical Cystectomy in Patients With Pathological Tumor Stage T3N0 Urothelial Carcinoma of the BladderJournal of Urology, VOL. 187, NO. 4, (1210-1214), Online publication date: 1-Apr-2012. Volume 184Issue 2August 2010Page: 470-474 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.Keywordsneoplasm stagingurinary bladdermortalitycarcinomaurotheliumMetricsAuthor Information Derya Tilki Department of Urology, Ludwig-Maximilians-University, Klinikum Grosshadern, Munich, Germany More articles by this author Robert S. Svatek University of Texas Southwestern Medical Center, Dallas, Texas More articles by this author Pierre I. Karakiewicz University of Montréal, Montréal, Québec, Canada More articles by this author Giacomo Novara University of Padua, Padua, Italy More articles by this author Michael Seitz Department of Urology, Ludwig-Maximilians-University, Klinikum Grosshadern, Munich, Germany More articles by this author Guru Sonpavde Baylor College of Medicine, Houston, Texas More articles by this author Amit Gupta University of Texas Southwestern Medical Center, Dallas, Texas Current address: Memorial Sloan-Kettering Cancer Center, New York, New York. More articles by this author Wassim Kassouf McGill University Health Centre, Montréal, Québec, Canada More articles by this author Yves Fradet Laval University, Québec City, Québec, Canada More articles by this author Vincenzo Ficarra University of Padua, Padua, Italy More articles by this author Eila Skinner University of Southern California, Los Angeles, California More articles by this author Yair Lotan University of Texas Southwestern Medical Center, Dallas, Texas More articles by this author Arthur I. Sagalowsky University of Texas Southwestern Medical Center, Dallas, Texas More articles by this author Christian G. Stief Department of Urology, Ludwig-Maximilians-University, Klinikum Grosshadern, Munich, Germany More articles by this author Oliver Reich Department of Urology, Ludwig-Maximilians-University, Klinikum Grosshadern, Munich, Germany More articles by this author Shahrokh F. Shariat Weill Medical College of Cornell University, New York, New York More articles by this author Expand All Advertisement PDF downloadLoading ...