Nikolaos Kalampokis1, Nikolaos Grivas1,2, Markus Ölschläger3, Fahmy Nabil Hassan3, Georgios Gakis4. 1. Department of Urology, G. Hatzikosta General Hospital, Ioannina, Greece. 2. Department of Urology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. 3. Department of Urology and Pediatric Urology, University Hospital of Würzburg, Julius Maximillians University, Oberdürrbacher Strasse 6, 97080, Würzburg, Germany. 4. Department of Urology and Pediatric Urology, University Hospital of Würzburg, Julius Maximillians University, Oberdürrbacher Strasse 6, 97080, Würzburg, Germany. georgios.gakis@gmail.com.
Abstract
PURPOSE OF REVIEW: To review the methods of improving surgical, oncological, and functional outcomes in women with bladder cancer treated with radical cystectomy. RECENT FINDINGS: Οrthotopic urinary diversion (ONB) is a safe option for well-selected women as it combines high rates of daytime and nighttime continence with exceptional oncologic outcomes. It is considered safe even for patients with limited lymph node disease and trigone involvement, as long as a preoperative biopsy of the bladder neck or an intraoperative frozen section analysis of distal urethral margin rules out malignant disease. Nerve-sparing techniques have shown promising results. For well-selected patients with early invasive disease, sparing of internal genitalia has proven to be oncologically safe. Yet, generally accepted and evidence-based oncological and functional follow-up schemes for women after radical cystectomy are still lacking. Properly designed prospective studies are needed with adequate number of participants in order to safely conclude about a broader use of pelvic organ-sparing cystectomy.
PURPOSE OF REVIEW: To review the methods of improving surgical, oncological, and functional outcomes in women with bladder cancer treated with radical cystectomy. RECENT FINDINGS: Οrthotopic urinary diversion (ONB) is a safe option for well-selected women as it combines high rates of daytime and nighttime continence with exceptional oncologic outcomes. It is considered safe even for patients with limited lymph node disease and trigone involvement, as long as a preoperative biopsy of the bladder neck or an intraoperative frozen section analysis of distal urethral margin rules out malignant disease. Nerve-sparing techniques have shown promising results. For well-selected patients with early invasive disease, sparing of internal genitalia has proven to be oncologically safe. Yet, generally accepted and evidence-based oncological and functional follow-up schemes for women after radical cystectomy are still lacking. Properly designed prospective studies are needed with adequate number of participants in order to safely conclude about a broader use of pelvic organ-sparing cystectomy.
Entities:
Keywords:
Bladder cancer; Diversion; Outcomes; Radical cystectomy; Women
Authors: Luis A Kluth; Malte Rieken; Evanguelos Xylinas; Matthew Kent; Michael Rink; Morgan Rouprêt; Nasim Sharifi; Asha Jamzadeh; Wassim Kassouf; Dharam Kaushik; Stephen A Boorjian; Florian Roghmann; Joachim Noldus; Alexandra Masson-Lecomte; Dimitri Vordos; Masaomi Ikeda; Kazumasa Matsumoto; Masayuki Hagiwara; Eiji Kikuchi; Yves Fradet; Jonathan Izawa; Ricardo Rendon; Adrian Fairey; Yair Lotan; Alexander Bachmann; Marc Zerbib; Margit Fisch; Douglas S Scherr; Andrew Vickers; Shahrokh F Shariat Journal: Eur Urol Date: 2013-12-05 Impact factor: 20.096
Authors: Florian Jentzmik; Andres J Schrader; Robert de Petriconi; Robert Hefty; Johannes Mueller; Johannes Doetterl; Alexander Eickhoff; Mark Schrader Journal: World J Urol Date: 2012-02-10 Impact factor: 4.226
Authors: Kang Su Cho; Joo Wan Seo; Sung Jin Park; Young Hoon Lee; Young Deuk Choi; Nam Hoon Cho; Seung Choul Yang; Sung Joon Hong Journal: Urol Int Date: 2009-05-11 Impact factor: 2.089
Authors: C M Samanic; M Kogevinas; D T Silverman; A Tardón; C Serra; N Malats; F X Real; A Carrato; R García-Closas; M Sala; J Lloreta; N Rothman; M Dosemeci Journal: Occup Environ Med Date: 2007-10-19 Impact factor: 4.402