Oncologic outcomes and survival in pT0 tumors after radical cystectomy in patients without neoadjuvant chemotherapy: results from a large multicentre collaborative study. - Université de Rennes Accéder directement au contenu
Article Dans Une Revue Annals of Surgical Oncology Année : 2011

Oncologic outcomes and survival in pT0 tumors after radical cystectomy in patients without neoadjuvant chemotherapy: results from a large multicentre collaborative study.

Stéphane Larré
  • Fonction : Auteur
Maryam Hitier
  • Fonction : Auteur
Jerome Rigaud
  • Fonction : Auteur
Jeremy Crew
  • Fonction : Auteur
Jean-Nicolas Cornu
  • Fonction : Auteur
Denis Champetier
  • Fonction : Auteur
François Rozet
  • Fonction : Auteur
Vincent Flamand
  • Fonction : Auteur
Cyrille Bastide
  • Fonction : Auteur
Xavier Durand
  • Fonction : Auteur
Pierre Lunardi
  • Fonction : Auteur
François-Xavier Nouhaud
  • Fonction : Auteur
Sophie Ferlicot
  • Fonction : Auteur
Jean-Jacques Patard
  • Fonction : Auteur
Aurélie Paule Floch
  • Fonction : Auteur
Jacques Irani
  • Fonction : Auteur
Benoit Peyronnet
Pascale Grès
  • Fonction : Auteur
Stéphane Droupy
  • Fonction : Auteur

Résumé

PURPOSE: To assess the postsurgical survival of patients with urothelial carcinoma of the bladder with pT0 tumor at pathologic examination of cystectomy specimens. METHODS: A multi-institutional, retrospective database was analyzed with data from 4758 radical cystectomy (RC) patients who underwent RC without neoadjuvant chemotherapy and who were diagnosed with pT0 on the basis of the pathologic specimen. Survival curves were estimated. A multivariate Cox model was used to evaluate the association between prognosis factors and disease recurrence or survival. RESULTS: Overall, 258 patients (5.4%) were included in the study. The median age was 64 years. At last resection, 171 tumors were invasive (at least pT2), and 87 were not. Median follow-up was 51 months. At multivariate analysis, initial location of the tumor and absence of lymphadenectomy were associated with tumor recurrence (P = 0.03 and P = 0.005, respectively) and specific mortality (P = 0.005 and 0.001, respectively). The main limitation of the study is its retrospective design, which is due to the rarity of this situation. Cancer-specific and recurrence-free survival rates were 89 and 85%, respectively, at 5 years and 82 and 80%, respectively, at 10 years. CONCLUSIONS: Despite acceptable oncological outcomes, patients with a pT0 tumor at the time of RC are still at risk of recurrence and progression and should not be considered to be entirely cured. In this population, stringent follow-up according to current recommendations should be effective.

Dates et versions

hal-00908162 , version 1 (22-11-2013)

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Morgan Rouprêt, Sarah J Drouin, Stéphane Larré, Yann Neuzillet, Henry Botto, et al.. Oncologic outcomes and survival in pT0 tumors after radical cystectomy in patients without neoadjuvant chemotherapy: results from a large multicentre collaborative study.. Annals of Surgical Oncology, 2011, 18 (13), pp.3833-8. ⟨10.1245/s10434-011-1824-y⟩. ⟨hal-00908162⟩
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