Abstract: PD66-12
Sources of Funding: None

Introduction

Patients who undergo radical cystectomy for urothelial cancer are at risk for upper tract urothelial carcinoma (UTUC). It is well-accepted that the removal of a formal bladder cuff at the time of radical nephroureterectomy (RNU) results in improved oncologic outcomes. However, the effects of ileal mucosal cuff excision in patients undergoing RNU who have had a prior urinary diversion has not been studied. To our knowledge, we present the first report on outcomes of ileal mucosal cuff management for patients undergoing RNU for UTUC.

Methods

Between 1995 and 2009 we retrospectively reviewed 483 patients at Mayo Clinic who underwent RNU for primary UTUC. We identified 41 patients who underwent RNU after having a previous radical cystectomy. Patients with mucosal cuff excision identified pathologically were analyzed and compared to those without a mucosal cuff. Kaplan Meier analyses were used to estimate recurrence free survival.

Results

Median age of the cohort was 72 (IQR 66, 77) and 32 (78%) were male. A total of 18 (43.9%) patients underwent ileal cuff excision. Tumor multifocality, non-muscle invasive tumors (

Conclusions

We found no significant difference in oncologic outcomes between patients with ileal mucosal cuff excision and those without a mucosal cuff at the time of RNU. Furthermore, there was no significant increase in intra- or post-operative complications by removing the mucosal cuff. In well-selected patients, oncologic outcomes may not be compromised by lack of ileal cuff excision.

Funding

None