Cancer Specific Outcomes in Patients With PT0 Disease Following Radical Cystectomy

Ganesh S. Palapattu, Shahrokh F. Shariat, Pierre I. Karakiewicz, Patrick J. Bastian, Craig G. Rogers, Gilad Amiel, Yair Lotan, Amnon Vazina, Amit Gupta, Arthur I Sagalowsky, Seth P. Lerner, Mark P. Schoenberg

Research output: Contribution to journalArticle

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Abstract

Purpose: We assessed clinical outcomes in patients found to have no evidence of disease, ie pT0, in the cystectomy specimen following radical cystectomy for transitional cell carcinoma. Materials and Methods: Between 1984 and 2003, 955 consecutive patients underwent bilateral pelvic lymphadenectomy and radical cystectomy for bladder cancer at 3 institutions, namely The Johns Hopkins Hospital, University of Texas Southwestern Medical Center and Baylor College of Medicine. Excluding nonTCC histology and patients with missing data resulted in 888 evaluable cases. Primary end points were recurrence-free survival and bladder cancer specific survival. Results: Final pathological evaluation revealed absent transitional cell carcinoma in the cystectomy specimen, ie pT0, in 59 patients (7%), of whom 2 (3%) had pathologically positive lymph nodes. Transurethral resection stage or clinical stage data were available on 56 patients (95%), including Tis in 5 (9%), Ta in 2 (4%), T1 in 18 (32%), T2 in 29 (52%) and T3 in 2 (4%). Overall 6 recurrences (10%) were noted, including cTis in 1 case, cT1 in 1, cT2 in 3 and cT3 in 1. Median followup in patients with pT0 disease was 56 months (range 3 to 183). Three patients (5%) died of bladder cancer and another 4 (7%) died of other causes. Five and 10-year bladder cancer progression-free and cancer specific survival estimates in patients with pT0 disease were 90% and 81%, and 95% and 85%, respectively. Conclusions: Despite excellent clinical outcomes in the majority of patients with no evidence of tumor on final pathological evaluation not all patients with pT0 disease in the cystectomy specimen are cured of bladder cancer. These events may even occur in patients with nonmuscle invasive or muscle invasive organ confined pathology at staging transurethral resection. Further study is needed to identify prognostic factors in this population.

Original languageEnglish (US)
Pages (from-to)1645-1649
Number of pages5
JournalJournal of Urology
Volume175
Issue number5
DOIs
StatePublished - May 2006

Fingerprint

Cystectomy
Urinary Bladder Neoplasms
Neoplasms
Transitional Cell Carcinoma
Survival
Recurrence
Lymph Node Excision
Histology
Lymph Nodes
Medicine
Pathology
Muscles

Keywords

  • bladder
  • bladder neoplasms
  • carcinoma
  • cystectomy
  • mortality
  • transitional cell

ASJC Scopus subject areas

  • Urology

Cite this

Palapattu, G. S., Shariat, S. F., Karakiewicz, P. I., Bastian, P. J., Rogers, C. G., Amiel, G., ... Schoenberg, M. P. (2006). Cancer Specific Outcomes in Patients With PT0 Disease Following Radical Cystectomy. Journal of Urology, 175(5), 1645-1649. https://doi.org/10.1016/S0022-5347(05)00995-X

Cancer Specific Outcomes in Patients With PT0 Disease Following Radical Cystectomy. / Palapattu, Ganesh S.; Shariat, Shahrokh F.; Karakiewicz, Pierre I.; Bastian, Patrick J.; Rogers, Craig G.; Amiel, Gilad; Lotan, Yair; Vazina, Amnon; Gupta, Amit; Sagalowsky, Arthur I; Lerner, Seth P.; Schoenberg, Mark P.

In: Journal of Urology, Vol. 175, No. 5, 05.2006, p. 1645-1649.

Research output: Contribution to journalArticle

Palapattu, GS, Shariat, SF, Karakiewicz, PI, Bastian, PJ, Rogers, CG, Amiel, G, Lotan, Y, Vazina, A, Gupta, A, Sagalowsky, AI, Lerner, SP & Schoenberg, MP 2006, 'Cancer Specific Outcomes in Patients With PT0 Disease Following Radical Cystectomy', Journal of Urology, vol. 175, no. 5, pp. 1645-1649. https://doi.org/10.1016/S0022-5347(05)00995-X
Palapattu GS, Shariat SF, Karakiewicz PI, Bastian PJ, Rogers CG, Amiel G et al. Cancer Specific Outcomes in Patients With PT0 Disease Following Radical Cystectomy. Journal of Urology. 2006 May;175(5):1645-1649. https://doi.org/10.1016/S0022-5347(05)00995-X
Palapattu, Ganesh S. ; Shariat, Shahrokh F. ; Karakiewicz, Pierre I. ; Bastian, Patrick J. ; Rogers, Craig G. ; Amiel, Gilad ; Lotan, Yair ; Vazina, Amnon ; Gupta, Amit ; Sagalowsky, Arthur I ; Lerner, Seth P. ; Schoenberg, Mark P. / Cancer Specific Outcomes in Patients With PT0 Disease Following Radical Cystectomy. In: Journal of Urology. 2006 ; Vol. 175, No. 5. pp. 1645-1649.
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abstract = "Purpose: We assessed clinical outcomes in patients found to have no evidence of disease, ie pT0, in the cystectomy specimen following radical cystectomy for transitional cell carcinoma. Materials and Methods: Between 1984 and 2003, 955 consecutive patients underwent bilateral pelvic lymphadenectomy and radical cystectomy for bladder cancer at 3 institutions, namely The Johns Hopkins Hospital, University of Texas Southwestern Medical Center and Baylor College of Medicine. Excluding nonTCC histology and patients with missing data resulted in 888 evaluable cases. Primary end points were recurrence-free survival and bladder cancer specific survival. Results: Final pathological evaluation revealed absent transitional cell carcinoma in the cystectomy specimen, ie pT0, in 59 patients (7{\%}), of whom 2 (3{\%}) had pathologically positive lymph nodes. Transurethral resection stage or clinical stage data were available on 56 patients (95{\%}), including Tis in 5 (9{\%}), Ta in 2 (4{\%}), T1 in 18 (32{\%}), T2 in 29 (52{\%}) and T3 in 2 (4{\%}). Overall 6 recurrences (10{\%}) were noted, including cTis in 1 case, cT1 in 1, cT2 in 3 and cT3 in 1. Median followup in patients with pT0 disease was 56 months (range 3 to 183). Three patients (5{\%}) died of bladder cancer and another 4 (7{\%}) died of other causes. Five and 10-year bladder cancer progression-free and cancer specific survival estimates in patients with pT0 disease were 90{\%} and 81{\%}, and 95{\%} and 85{\%}, respectively. Conclusions: Despite excellent clinical outcomes in the majority of patients with no evidence of tumor on final pathological evaluation not all patients with pT0 disease in the cystectomy specimen are cured of bladder cancer. These events may even occur in patients with nonmuscle invasive or muscle invasive organ confined pathology at staging transurethral resection. Further study is needed to identify prognostic factors in this population.",
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AU - Bastian, Patrick J.

AU - Rogers, Craig G.

AU - Amiel, Gilad

AU - Lotan, Yair

AU - Vazina, Amnon

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