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Current Urology Reports Oct 2016Optical imaging is a relatively inexpensive, fast, and sensitive addition to a surgeon's arsenal for the non-invasive detection of malignant dissemination. Optical... (Review)
Review
Optical imaging is a relatively inexpensive, fast, and sensitive addition to a surgeon's arsenal for the non-invasive detection of malignant dissemination. Optical cameras in the near infrared spectrum are able to successfully identify injected indocyanine green in lymphatic channels and sentinel lymph nodes. The use of this technology is now being used in the operating room to help with lymph node dissection and improve the prognosis of patients diagnosed with muscle invasive bladder cancer. Indocyanine green has the potential for many more applications due to its versatility. In the future, there is a potential to use it for lymphangiography during nephroureterctomy for upper tract urothelial carcinoma, adrenal surgery for partial or radical adrenalectomy. Further investigations at multiple centers will validate this technique and its efficiency.
Topics: Coloring Agents; Cystectomy; Drainage; Fluorescence; Humans; Indocyanine Green; Intraoperative Period; Male; Molecular Targeted Therapy; Optical Imaging; Sentinel Lymph Node; Urinary Bladder Neoplasms
PubMed: 27539291
DOI: 10.1007/s11934-016-0633-z -
Clinical Genitourinary Cancer Apr 2020The present study tested cancer-specific (CSM) and overall mortality (OM) after partial cystectomy (PC) for variant histology bladder cancer (non-urothelial carcinoma of... (Comparative Study)
Comparative Study
BACKGROUND
The present study tested cancer-specific (CSM) and overall mortality (OM) after partial cystectomy (PC) for variant histology bladder cancer (non-urothelial carcinoma of the urinary bladder UCUB), relative to UCUB and relative to radical cystectomy (RC).
MATERIALS AND METHODS
Within the Surveillance, Epidemiology, and End Results registry (2001-2016), we identified patients with stage T1-T2N0M0 non-UCUB and UCUB who had undergone PC or RC. Non-UCUB included adenocarcinoma, squamous carcinoma, neuroendocrine carcinoma, and other histologic subtypes. First, CSM and OM after PC were compared between the non-UCUB and UCUB groups. Second, CSM and OM after PC were compared with RC in the non-UCUB group. Kaplan Meier plots and multivariable Cox regression models were used before and after inverse probability of treatment weighting.
RESULTS
Overall, 248 patients (16.3%) treated with PC had had non-UCUB. Of the 248 cases, 115 (46.5%), 50 (20%), 34 (14%), and 49 (19.5%) were adenocarcinoma, squamous carcinoma, neuroendocrine carcinoma, and other histologic subtypes, respectively. The comparison between PC in the non-UCUB and PC in the UCUB group showed higher CSM (hazard ratio, 1.4; P = .03) but the same OM rates (hazard ratio, 1.1; P = .7) in the non-UCUB group. The comparison between PC and RC for the non-UCUB group showed no CSM or OM differences.
CONCLUSIONS
PC for non-UCUB was associated with higher CSM compared with PC for UCUB. However, PC instead of RC for select patients with non-UCUB appears not to undermine cancer-control outcomes. Thus, the excess CSM is probably unrelated to cystectomy type but could originate from differences in the tumor biology. These results could act as hypothesis generating for the design of future trials.
Topics: Aged; Aged, 80 and over; Carcinoma, Transitional Cell; Clinical Decision-Making; Cystectomy; Female; Follow-Up Studies; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Patient Selection; Retrospective Studies; SEER Program; Urinary Bladder; Urinary Bladder Neoplasms
PubMed: 32035800
DOI: 10.1016/j.clgc.2019.10.016 -
Asian Journal of Surgery Jan 2024
Topics: Humans; Cystectomy; Urinary Bladder; Cystitis; Laparoscopy
PubMed: 37833217
DOI: 10.1016/j.asjsur.2023.09.167 -
The Journal of Small Animal Practice Oct 1996Partial cystectomy was performed in 11 dogs with bladder neoplasia (10 with transitional cell carcinoma and one with rhabdomyosarcoma). Between 40 and 70 per cent of the...
Partial cystectomy was performed in 11 dogs with bladder neoplasia (10 with transitional cell carcinoma and one with rhabdomyosarcoma). Between 40 and 70 per cent of the bladder was excised during the partial cystectomies. In eight dogs, all the grossly visible tumour was excised but on histopathological examination of the excised tissue, neoplastic tissue was found to extend to the surgical margins in four of these dogs. A ureteral stoma was excised with the tumour in four dogs necessitating ureteral reimplantation; one dog had both ureteral stomas excised and bilateral ureteral reimplantation. The bladder incision dehisced in two dogs, necessitating a second surgery. Six dogs were pollakiuric after surgery. Pollakiuria resolved within two months in four dogs and persisted in two dogs. None was incontinent. Local tumour recurrence was suspected in nine dogs based on imaging studies and confirmed in five dogs during post mortem examination. Five dogs were euthanased two to seven months after surgery. Six dogs survived at least one year, two of these dogs remain alive at 17 and 27 months after surgery. It is concluded that partial cystectomy may provide local control of bladder neoplasia.
Topics: Animals; Carcinoma, Transitional Cell; Cystectomy; Dog Diseases; Dogs; Female; Male; Rhabdomyosarcoma; Treatment Outcome; Urinary Bladder Neoplasms
PubMed: 8912242
DOI: 10.1111/j.1748-5827.1996.tb01745.x -
Clinics (Sao Paulo, Brazil) Dec 2008To report our initial experiences with laparoscopic partial cystectomy for urachal and bladder malignancy.
PURPOSE
To report our initial experiences with laparoscopic partial cystectomy for urachal and bladder malignancy.
MATERIALS AND METHODS
Between March 2002 and October 2004, laparoscopic partial cystectomy was performed in 6 cases at 3 institutions; 3 cases were urachal adenocarcinomas and the remaining 3 cases were bladder transitional cell carcinomas. All patients were male, with a median age of 55 years (45-72 years). Gross hematuria was the presenting symptom in all patients, and diagnosis was established with trans-urethral resection bladder tumor in 2 patients and by means of cystoscopic biopsy in the remaining 4 patients. Laparoscopic partial cystectomy was performed using the transperitoneal approach under cystoscopic guidance. In each case, the surgical specimen was removed intact entrapped in an impermeable bag. One patient with para-ureteral diverticulum transitional cell carcinoma required concomitant ureteral reimplantation.
RESULTS
All six procedures were completed laparoscopically without open conversion. The median operating time was 110 minutes (90-220) with a median estimated blood loss of 70 mL (50-100). Frozen section evaluations of bladder margins were routinely obtained and were negative for cancer in all cases. The median hospital stay was 2.5 days (2-4) and the duration of catheterization was 7 days. There were no intraoperative or postoperative complications. Final histopathology confirmed urachal adenocarcinoma in 3 cases and bladder transitional cell carcinoma in 3 cases. At a median follow-up of 28.5 months (range: 26 to 44 months), there was no evidence of recurrent disease as evidenced by radiologic or cystoscopic evaluation.
CONCLUSIONS
Laparoscopic partial cystectomy in carefully selected patients with urachal and bladder cancer is feasible and safe, offering a promising and minimally invasive alternative for these patients.
Topics: Adenocarcinoma; Aged; Carcinoma, Transitional Cell; Cystectomy; Humans; Laparoscopy; Male; Middle Aged; Neoplasm Staging; Treatment Outcome; Urachus; Urinary Bladder Neoplasms
PubMed: 19060992
DOI: 10.1590/s1807-59322008000600004 -
BJU International Apr 2024To compare perioperative morbidity, functional and quality-of-life (QoL) outcomes in patients with partial cystectomy vs radical cystectomy as part of pelvic...
OBJECTIVE
To compare perioperative morbidity, functional and quality-of-life (QoL) outcomes in patients with partial cystectomy vs radical cystectomy as part of pelvic exenteration.
PATIENTS AND METHODS
Retrospective analysis of a prospectively maintained database of pelvic exenteration patients (1998-2021) was conducted in a single centre. Study outcomes included postoperative complications, quality-of-life, functional and stoma-related outcomes. The 36-item Short-Form Health Survey Physical and Mental Health Components, Functional Assessment of Cancer Therapy-Colorectal questionnaires and Distress Thermometer were available pre- and postoperatively. QoL outcomes were compared at the various time points. Stoma embarrassment and care scores were compared between patients with a colostomy, urostomy, and both.
RESULTS
Urological complications were similar between both groups, but patients with partial cystectomy experienced less wound-related complications. Overall, 34/81 (42%) partial cystectomy patients reported one or more long-term voiding complication (i.e., incontinence [17 patients], frequency [six], retention [three], high post-voiding residuals [10], permanent suprapubic catheter/indwelling catheter [14], recurrent urinary tract infection [nine], percutaneous nephrostomy [three], progression to urostomy [three]). The QoL improved following surgery in both the partial and radical cystectomy groups, differences between cohorts were not significant. Patients with two stomas reported higher embarrassment scores than patients with one stoma, although this did not result in more difficulties in stoma care.
CONCLUSIONS
Partial cystectomy patients have fewer postoperative wound-related complications than radical cystectomy patients, but often experience long-term voiding issues. The QoL outcomes are similar for both cohorts, with significant improvement following surgery.
Topics: Humans; Cystectomy; Pelvic Exenteration; Quality of Life; Retrospective Studies; Urinary Diversion; Postoperative Complications; Urinary Bladder Neoplasms
PubMed: 38379076
DOI: 10.1111/bju.16299 -
Veterinary and Comparative Oncology Dec 2017Canine transitional cell carcinoma (TCC) of the bladder has historically been treated with a combination of chemotherapy, cyclooxygenase inhibitors and radiation...
Canine transitional cell carcinoma (TCC) of the bladder has historically been treated with a combination of chemotherapy, cyclooxygenase inhibitors and radiation therapy. While surgery has been used to treat TCC of the bladder, its efficacy has yet to be established. Thirty-seven client owned dogs that underwent partial cystectomy +/- various nonsurgical treatments for TCC were retrospectively evaluated. The overall median progression-free interval (PFI) was 235 days and the median survival time (ST) was 348 days. Prognostic factors identified on univariate analysis significant for ST were age, tumor location, full thickness excision and frequency of piroxicam administration. Prognostic factors significant for PFI were full thickness excision and frequency of piroxicam administration. The median ST with partial cystectomy and daily piroxicam therapy, with or without chemotherapy, was 772 days. Dogs with non-trigonal bladder TCC treated with full thickness partial cystectomy and daily piroxicam (+/- chemotherapy) may have improved outcome compared to dogs treated with medical therapy.
Topics: Animals; Carcinoma, Transitional Cell; Cyclooxygenase Inhibitors; Cystectomy; Dog Diseases; Dogs; Female; Male; Piroxicam; Retrospective Studies; Treatment Outcome; Urinary Bladder Neoplasms
PubMed: 28217972
DOI: 10.1111/vco.12286 -
Expert Review of Anticancer Therapy Dec 2018Radical cystectomy is the standard therapy for patients with muscle-invasive bladder cancer. Organ-preserving surgical procedures have been established as alternatives... (Review)
Review
Radical cystectomy is the standard therapy for patients with muscle-invasive bladder cancer. Organ-preserving surgical procedures have been established as alternatives to radical surgery for localized malignancies in other anatomic sites. Trimodal therapy consisting of radiation therapy, chemotherapy, and either transurethral resection of the bladder or partial cystectomy is an effective treatment for selected patients with muscle-invasive bladder cancer that allows for preservation of the urinary bladder. Areas covered: This review provides an overview of the value of trimodal therapy in the treatment of muscle-invasive bladder cancer. Expert commentary: Prerequisites for trimodal therapy for bladder cancer include: good bladder function, unifocal cT2 urothelial carcinoma of the bladder, and absence of hydronephrosis. Careful selection of patients and accurate assessment of the anatomic extent of the tumor is important for patient safety. The basis for successful trimodal therapy is complete transurethral resection of the tumor, followed by radiation therapy with concurrent radiosensitizing chemotherapy. Cystoscopic controls and follow-up biopsies should be performed at completion of adjuvant therapy or shortly after induction of trimodal therapy to identify nonresponders for whom salvage radical cystectomy may be indicated.
Topics: Animals; Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Cystectomy; Humans; Neoplasm Invasiveness; Organ Sparing Treatments; Patient Selection; Salvage Therapy; Urinary Bladder Neoplasms
PubMed: 30324833
DOI: 10.1080/14737140.2018.1535314 -
BMJ Case Reports Aug 2021Bladder endometriosis accounts for 70%-85% cases of urinary tract endometriosis. A high index of suspicion is needed to diagnose this condition as most women have...
Bladder endometriosis accounts for 70%-85% cases of urinary tract endometriosis. A high index of suspicion is needed to diagnose this condition as most women have associated pelvic and menstrual complaints. The presence of cyclical haematuria along with tender anterior vaginal wall should alert the gynaecologist or urologist to consider this rare entity. Treatment is medical therapy followed by surgery when needed. Transurethral resection of endometriotic spot is the commonly used approach but to completely excise the endometriotic nodule, bladder resection at the site of nodule is needed along with repair of cut bladder margins. Herein, we describe a dual surgical approach where the margins of the endometriotic spot were delineated and cut using cystoscopy, followed by robotic approach to completely excise the nodule along with bladder repair. Robotic approach seems safer and easier in this complex surgery owing to dense adhesions in such cases.
Topics: Cystectomy; Cystoscopy; Endometriosis; Female; Humans; Robotic Surgical Procedures; Robotics; Urinary Bladder
PubMed: 34429296
DOI: 10.1136/bcr-2021-244342 -
Japanese Journal of Clinical Oncology Mar 2023To compare renal function (RF) outcomes after bladder-preserving tetramodal therapy against muscle-invasive bladder cancer (MIBC) to those after radical cystectomy (RC).
Renal function outcome after selective bladder-preserving tetramodality therapy consisting of maximal transurethral resection, induction chemoradiotherapy and consolidative partial cystectomy in comparison with radical cystectomy for patients with muscle-invasive bladder cancer: a two-centre...
OBJECTIVE
To compare renal function (RF) outcomes after bladder-preserving tetramodal therapy against muscle-invasive bladder cancer (MIBC) to those after radical cystectomy (RC).
METHODS
This study included 95 patients treated with tetramodal therapy consisting of transurethral bladder tumour resection, chemoradiotherapy and partial cystectomy (PC) and 300 patients treated with RC. The annual change in the estimated glomerular filtration rate (eGFR) was compared using the linear mixed model. Renal impairment was defined as a >25% decrease from the pretreatment eGFR, and renal impairment-free survival (RIFS) was calculated. The association between treatment type and renal impairment was assessed.
RESULTS
The number of patients who received neoadjuvant chemotherapy was 8 (8.4%) in the tetramodal therapy group and 75 (25.0%) in the RC group. After the inverse probability of treatment weighting adjustments, the baseline characteristics were balanced between the treatment groups. The mean eGFR before treatment in tetramodal therapy and RC groups was 69.4 and 69.6 mL/min/1.73 m2 and declined with a slope of -0.7 and -1.5 mL/min/1.73 m2/year, respectively. The annual deterioration rate of post-treatment eGFR in the tetramodal therapy group was milder than in the RC group. The 5-year RIFS rate in the tetramodal therapy and the RC groups was 91.2 and 85.2%, respectively. Tetramodal therapy was an independent factor of better RIFS compared with RC.
CONCLUSIONS
RF was better preserved after tetramodal therapy than after radical therapy; however, even after tetramodal therapy, the eGFR decreased, and a non-negligible proportion of patients developed renal impairment.
Topics: Humans; Urinary Bladder; Cystectomy; Retrospective Studies; Urinary Bladder Neoplasms; Chemoradiotherapy; Muscles; Kidney; Neoplasm Invasiveness
PubMed: 36524369
DOI: 10.1093/jjco/hyac190