The main reason for cancer death in patients treated with radical cystectomy has been associated with the development of distant metastasis. Meanwhile, long-term survival after local recurrence is also extremely rare. Thus, local recurrence is thought to be as important as distant metastasis for disease specific survival.
In the study, the researchers identified a study population of 146 consecutive patients treated surgically for invasive bladder cancer between 1987 and 2003. Local recurrence developed in 26 or 17.8 per cent of the 146 patients at a median of ten months after cystectomy.
Local recurrence was independently associated with distant metastasis in addition to the number of retrieved lymph nodes. The two- and five-year metastasis free rates were 86.7 per cent and 76.5 per cent in patients without local recurrence and 26.5 per cent and zero per cent in those with local recurrence.
The presence or absence of local recurrence and tumour grade were independent predictors of disease specific survival. The two- and five-year disease specific survival rates were 93.5 per cent and 88.3 per cent in patients without local recurrence and 55.1 per cent and 35.4 per cent in those with local recurrence. The presence of concomitant adenocarcinoma component, pathological nodal involvement, and the number of retrieved lymph nodes were independent predictors of local recurrence.
The scientists conclude that local recurrence is independently associated with distant metastasis and disease specific survival. They hope that the predictive factors described can help select a subgroup of patients who would benefit from optimal local control. Based on the study’s results, extensive lymph node dissection would be of benefit to reduce local recurrence, the researchers argue.
MEDICA.de; Source: UroToday