Login to Access Video or Poster Abstract: MP58-15
Sources of Funding: non

Introduction

To compare patterns of tumor recurrence of common histological types of bladder cancer after radical cystectomy. Predictors of cancer specific survival (CSS) were also identified.

Methods

The records of 1737 consecutive patients treated with radical cystectomy between January 2004 till February 2014 were reviewed. _x000D_ A total of 937, 318, 223and 70 patients were diagnosed with urothelial carcinoma (UC), SCC,UC with squamous differentiation (SqD) and adenocarcinoma (AC) respectively. Clinical tumor recurrences were classified as local, when recurred in the soft tissue of pelvis and / or pelvic lymph nodes. Distant metastasis, on those recurred in remote sites including extrapelvic lymph nodes._x000D_ Cancer specific survival (CSS) was estimated using Kaplan-Meier survival method and compared with log rank test._x000D_

Results

Mean patient age was 58.4±8.1 years. Median follow up period was 23 months (IQR 9-57 months). Patients’ characteristics are demonstrated in Table1._x000D_ Five year CSS was 77.9% , 77.8% , 67.3% and 59.8% for SCC, AC, UC and SqD respectively (p = 0.009). _x000D_ Patients with SqD had the highest incidence of local pelvic recurrence reaching 21% followed by SCC (15.4%). Distant metastasis was observed in 157 (16.8%) and 41(18.4%) patients with UC and SqD respectively in comparison to 7(10%) and 20 (6.3%) in adenocarcinoma and SCC cases respectively. Bone was the commonest site of distant metastasis._x000D_ The independent prognostic factors of CSS , of all treated patients, on multivariate analysis were T stage (pT3-4 vs pT0-2) (HR 3, 95% CI 2.3-3.9, P < 0.0001), lymph node metastasis (HR 1.7, 95% CI 1.29-2.2, P <0.0001), lymphovascular invasion (HR 1.5, 95% CI 1.1-2, P = 0.001) and obstructive uropathy at presentation (HR 2.2, 95% CI 1.4- 3.4, P < 0.0001)._x000D_

Conclusions

After radical cystectomy, distant tumor metastasis was more frequently observed in UC and its variant while local recurrence was more common in patients with SCC and adenocarcinoma.

Funding

non