Local recurrences after radical cystectomy in bladder cancer patients

Abstract

BACKGROUND: Radical cystectomy is the standard treatment for patients with muscle-invasive bladder cancer and superficial neoplasms in cases of resistance to intravesical immunochemotherapy. AIM: To establish the frequency of local pelvic recurrence in patients with bladder cancer after radical cystectomy. MATERIALS AND METHODS: From 1997 to 2022 radical cystectomy was performed in 407 patients with bladder cancer: 344 (84.5%) men and 63 (15.5%) women. Orthotopic urinary diversion methods were performed in 302 (74.2%) patients, including gastrocystoplasty 24 (5.9%), ileocystoplasty 253 (63.8%) and sigmocystoplasty 25 (6.1%) patients. Continent skin diversion of urine was performed in 13 (3.2%) patients, ureter transplantation into the sigmoid colon in 42 (10.3%) patients, and ureterocutaneostomy in 50 (12.3%) patients. RESULTS: Local recurrence in the pelvis after radical cystectomy was observed in 33 (8.1%) patients: 27 (81.8%) men and 6 (18.2%) women. The average age of men with relapses was 58.7 11.7 years (from 43 to 73 years), women 50.0 7.8 years (from 24 to 65 years). Simultaneous metastatic lesions of internal organs were detected in 6 (18.2%) patients. Local pelvic recurrence after radical cystectomy occurred more often in lymphopositive patients with extravesical spread of the primary low-grade tumor. The median time from radical cystectomy to detection of pelvic recurrence was 7.0 months, from the moment of detection of pelvic recurrence to the death of the patient 4.5 months. CONCLUSIONS: The frequency of local pelvic recurrence of bladder cancer after radical cystectomy is 8.1%. The survival rate of patients with local pelvic recurrence is extremely low.