© The Author (2008). Published by Oxford University Press. All rights reserved
The Predictors of Local Recurrence after Radical Cystectomy in Patients with Invasive Bladder Cancer
Department of Urology, Keio University School of Medicine, Tokyo, Japan
For reprints and all correspondence: Eiji Kikuchi, Department of Urology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. E-mail: eiji-k{at}kb3.so-net.ne.jp
Received March 2, 2008; accepted April 10, 2008
Objectives: To examine the association between local recurrence and distant metastasis or disease-specific survival and identify independent factor predictors for local recurrence.
Methods: We identified a study population of 146 consecutive patients treated surgically for invasive bladder cancer at our institution between 1987 and 2003. We clarified the relationship among local recurrence, distant metastasis and disease-specific survival and identified significant predictors for local recurrence.
Results: Local recurrence developed in 26 (17.8%) of the 146 patients at a median of 10 months (range, 1–73 months) after cystectomy. It was independently associated with distant metastasis in addition to the number of retrieved lymph nodes. The 2- and 5-year metastasis-free rates were 86.7 and 76.5% in patients without local recurrence and 26.5 and 0% in those with local recurrence (P < 0.001), respectively. The presence or absence of local recurrence and tumor grade were independent predictors of disease-specific survival. The 2- and 5-year disease-specific survival rates were 93.5 and 88.3% in patients without local recurrence and 55.1 and 35.4% in those with local recurrence (P < 0.001). The presence of concomitant adenocarcinoma component, pathological nodal involvement and the number of retrieved lymph nodes were independent predictors of local recurrence.
Conclusions: Local recurrence was independently associated with distant metastasis and disease-specific survival. Patients who have the predictive factors described above may benefit from integrated surgical therapies with post-operative adjuvant chemotherapy.
Key Words: bladder cancer • local recurrence • distant metastasis