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Erschienen in: Medical Oncology 5/2017

01.05.2017 | Original Paper

Detecting asymptomatic recurrence after radical cystectomy contributes to better prognosis in patients with muscle-invasive bladder cancer

verfasst von: Ayumu Kusaka, Shingo Hatakeyama, Shogo Hosogoe, Itsuto Hamano, Hiromichi Iwamura, Naoki Fujita, Ken Fukushi, Takuma Narita, Hayato Yamamoto, Yuki Tobisawa, Tohru Yoneyama, Takahiro Yoneyama, Yasuhiro Hashimoto, Takuya Koie, Hiroyuki Ito, Kazuaki Yoshikawa, Toshiaki Kawaguchi, Chikara Ohyama

Erschienen in: Medical Oncology | Ausgabe 5/2017

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Abstract

The prognostic benefit of oncological follow-up to detect asymptomatic recurrence after radical cystectomy (RC) remains unclear. We aimed to assess whether routine follow-up to detect asymptomatic recurrence after RC improves patient survival. We retrospectively analyzed 581 RC cases for muscle-invasive bladder cancer at four hospitals between May 1996 and February 2017. All patients had regular follow-up examinations with urine cytology, blood biochemical tests, and computed tomography after RC. We investigated the first site and date of tumor recurrence. Overall survival in patients with recurrence stratified by the mode of recurrence (asymptomatic group vs. symptomatic group) was estimated using the Kaplan–Meier method with the log-rank test. Cox proportional hazards regression analysis via inverse probability of treatment weighting (IPTW) was used to evaluate the impact of the mode of diagnosing recurrence on survival. Of the 581 patients, 175 experienced relapse. Among those, 12 without adequate data were excluded. Of the remaining 163 patients, 76 (47%) were asymptomatic and 87 (53%) were symptomatic at the time of diagnosis. The most common recurrence site and symptom were lymph nodes (47%) and pain (53%), respectively. Time of overall survival after RC and from recurrence to death was significantly longer in the asymptomatic group than in the symptomatic group. A multivariate Cox regression analysis using IPTW showed that in the patients with symptomatic recurrence was an independent risk factor for overall survival after RC and survival from recurrence to death. Routine oncological follow-up for detection of asymptomatic recurrence contributes to a better prognosis after RC.
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Metadaten
Titel
Detecting asymptomatic recurrence after radical cystectomy contributes to better prognosis in patients with muscle-invasive bladder cancer
verfasst von
Ayumu Kusaka
Shingo Hatakeyama
Shogo Hosogoe
Itsuto Hamano
Hiromichi Iwamura
Naoki Fujita
Ken Fukushi
Takuma Narita
Hayato Yamamoto
Yuki Tobisawa
Tohru Yoneyama
Takahiro Yoneyama
Yasuhiro Hashimoto
Takuya Koie
Hiroyuki Ito
Kazuaki Yoshikawa
Toshiaki Kawaguchi
Chikara Ohyama
Publikationsdatum
01.05.2017
Verlag
Springer US
Erschienen in
Medical Oncology / Ausgabe 5/2017
Print ISSN: 1357-0560
Elektronische ISSN: 1559-131X
DOI
https://doi.org/10.1007/s12032-017-0955-9

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