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Laukhtina E, Boehm A, Peyronnet B, Bravi CA, Batista Da Costa J, Soria F, D'Andrea D, Rajwa P, Quhal F, Yanagisawa T, König F, Mostafaei H, Enikeev D, Ingels A, Verhoest G, D'Hondt F, Mottrie A, Joniau S, Van Poppel H, de la Taille A, Bensalah K, Bruyère F, Shariat SF, Pradere B. Urethrectomy at the time of radical cystectomy for non-metastatic urothelial carcinoma of the bladder: a collaborative multicenter study. World J Urol 2022; 40:1689-1696. [PMID: 35596017 PMCID: PMC9236994 DOI: 10.1007/s00345-022-04025-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/13/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The optimal management of the urethra in patients planned for radical cystectomy (RC) remains unclear. We sought to evaluate the impact of urethrectomy on perioperative and oncological outcomes in patients treated with RC for non-metastatic urothelial carcinoma of the bladder (UCB). MATERIALS AND METHODS We assessed the retrospective data from patients treated with RC for UCB of five European University Hospitals. Associations of urethrectomy with progression-free (PFS), cancer-free (CSS), and overall (OS) survivals were assessed in univariable and multivariable Cox regression models. We performed a subgroup analysis in patients at high risk for urethral recurrence (UR) (urethral invasion and/or bladder neck invasion and/or multifocality and/or prostatic urethra involvement). RESULTS A total of 887 non-metastatic UCB patients were included. Among them, 146 patients underwent urethrectomy at the time of RC. Urethrectomy was performed more often in patients with urethral invasion, T3/4 tumor stage, CIS, positive frozen section analysis of the urethra, and those who received neoadjuvant chemotherapy, underwent robotic RC, and/or received an ileal conduit urinary diversion (all p < 0.001). Estimated blood loss and the postoperative complication rate were comparable between patients who received an urethrectomy and those who did not. Urethrectomy during RC was not associated with PFS (HR 0.83, p = 0.17), CSS (HR 0.93, p = 0.67), or OS (HR 1.08, p = 0.58). In the subgroup of 276 patients at high risk for UR, urethrectomy at the time of RC decreased the risk of progression (HR 0.58, p = 0.04). CONCLUSION In our study, urethrectomy at the time of RC seems to benefit only patients at high risk for UR. Adequate risk assessment of UCB patients' history may allow for better clinical decision-making and patient counseling.
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Affiliation(s)
- Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Axelle Boehm
- Department of Urology, University Hospital of Tours, Tours, France
| | - Benoit Peyronnet
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - Carlo Andrea Bravi
- Unit of Urology, Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.,ORSI Academy, Melle, Belgium
| | - Jose Batista Da Costa
- Department of Urology, University Hospital Henri Mondor, AP-HP, UPEC, AP-HP, 51 Avenue du Maréchal de Lattre de Tassigny, 95010, Créteil Cedex, France
| | - Francesco Soria
- Division of Urology, Department of Surgical Sciences, AOU Città della Salute e della Scienza di Torino, Torino School of Medicine, Turin, Italy
| | - David D'Andrea
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Pawel Rajwa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Fahad Quhal
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Takafumi Yanagisawa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Frederik König
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Department of Urology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Hadi Mostafaei
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Alexandre Ingels
- Department of Urology, University Hospital Henri Mondor, AP-HP, UPEC, AP-HP, 51 Avenue du Maréchal de Lattre de Tassigny, 95010, Créteil Cedex, France
| | - Gregory Verhoest
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - Frederiek D'Hondt
- Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.,ORSI Academy, Melle, Belgium
| | - Alexandre Mottrie
- Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.,ORSI Academy, Melle, Belgium
| | - Steven Joniau
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | | | - Alexandre de la Taille
- Department of Urology, University Hospital Henri Mondor, AP-HP, UPEC, AP-HP, 51 Avenue du Maréchal de Lattre de Tassigny, 95010, Créteil Cedex, France
| | - Karim Bensalah
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - Franck Bruyère
- Department of Urology, University Hospital of Tours, Tours, France
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.,Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.,Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.,Department of Urology, Weill Cornell Medical College, New York, NY, USA.,Department of Urology, University of Texas Southwestern, Dallas, TX, USA.,Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.,Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. .,Department of Urology, La Croix Du Sud Hospital, Quint Fonsegrives, France.
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Ingels A, Bibas S, Abdessater M, Tabourin T, Roupret M, Chartier-Kastler E, Barker G, Tobbal N, Doizi S, Cussenot O, Prost D, Desgrandchamps F, Ouzaid I, Rollin P, Hermieu JF, Audenet F, Userovici M, Mejean A, Anract J, Roux S, Peyromaure M, Couteau N, Lebacle C, Irani J, Vordos D, Yiou R, Hoznek A, Champy CM, Batista Da Costa J, de la Taille A. Urology surgical activity and COVID-19: risk assessment at the epidemic peak: a Parisian multicentre experience. BJU Int 2020; 126:436-440. [PMID: 32640121 PMCID: PMC7361920 DOI: 10.1111/bju.15164] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Alexandre Ingels
- Department of Urology, UPEC - Henri Mondor Hospital, AP-HP, Creteil, France
| | - Steeven Bibas
- Department of Urology, UPEC - Henri Mondor Hospital, AP-HP, Creteil, France
| | - Maher Abdessater
- Department of Urology, AP-HP, Pitié-Salpétrière Hospital, Sorbonne Université, Paris
| | - Thomas Tabourin
- Department of Urology, AP-HP, Pitié-Salpétrière Hospital, Sorbonne Université, Paris
| | - Morgan Roupret
- Department of Urology, AP-HP, Pitié-Salpétrière Hospital, Sorbonne Université, Paris
| | | | - Gwendolyn Barker
- Department of Urology, AP-HP, Tenon Hospital, Sorbonne Université, Paris, France
| | - Nouha Tobbal
- Department of Urology, AP-HP, Tenon Hospital, Sorbonne Université, Paris, France
| | - Steeve Doizi
- Department of Urology, AP-HP, Tenon Hospital, Sorbonne Université, Paris, France
| | - Olivier Cussenot
- Department of Urology, AP-HP, Tenon Hospital, Sorbonne Université, Paris, France
| | - Doriane Prost
- Department of Urology, AP-HP, Saint-Louis Hospital, Paris, France
| | | | - Idir Ouzaid
- Department of Urology, AP-HP, Bichat Hospital, Paris, France
| | - Paul Rollin
- Department of Urology, AP-HP, Bichat Hospital, Paris, France
| | | | | | | | - Arnaud Mejean
- Department of Urology, AP-HP, HEGP Hospital, Paris, France
| | - Julien Anract
- Department of Urology, AP-HP, Cochin Hospital, Paris, France
| | - Sabine Roux
- Department of Urology, AP-HP, Cochin Hospital, Paris, France
| | | | - Nicolas Couteau
- Department of Urology, AP-HP, Kremlin-Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Cédric Lebacle
- Department of Urology, AP-HP, Kremlin-Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Jacques Irani
- Department of Urology, AP-HP, Kremlin-Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Dimitri Vordos
- Department of Urology, UPEC - Henri Mondor Hospital, AP-HP, Creteil, France
| | - René Yiou
- Department of Urology, UPEC - Henri Mondor Hospital, AP-HP, Creteil, France
| | - Andras Hoznek
- Department of Urology, UPEC - Henri Mondor Hospital, AP-HP, Creteil, France
| | - Cecile M Champy
- Department of Urology, UPEC - Henri Mondor Hospital, AP-HP, Creteil, France
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