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Časopis Clinical urology – Článok Treatment results of bladder tumours by radical cystectomy in 130 patients – 10-year experience

Clinical urology

Postgraduate scientific medical journal. Magazine Slovak Association of Urology.
Period 3x per year
1336-7579
The journal is indexed in the Slovak National Bibliography, Bibliographiia Medica Slovaca (BMS) and listed to citation database CiBaMed. All articles are reviewed. The publisher does not bear any responsibility for data and opinions of particular authors of the articles or advertisements. The articles on grey pages are company promotions or non reviewed information, an author is responsible for the content. Any reproduction of the content is allowed only with direct consent of the editorial office.
Predplatné
Clinical urology
Clinical urology
Postgraduate scientific medical journal. Magazine Slovak Association of Urology.
Period 3x per year
Predplatné
Téma: Urological oncology

Treatment results of bladder tumours by radical cystectomy in 130 patients – 10-year experience

Ján Ľupták, Ján Šulgan, Boris Eliáš, Ján Kliment, sen., Ján Švihra, sen., Ján Kliment jr., Igor Sopilko, Roman Tomaškin, Anna Rašková, Pavol Slávik

Aim: Radical cystectomy (RC) with pelvic lymph node dissection (LND) is a standard treatment for localized muscle infiltrating bladder tumours, non-infiltrative tumours after failure of intravesical treatment as well as for patients with extensive papillary tumours unsolvable endoscopically. This study aimed to re-evaluate the results of RC and LND in patients with bladder cancer.
Material and Methods: We retrospectively evaluated 128 patients (115 males and 13 females) after RC and urinary diversion at the age of 37-90 years (median 69 years) who were operated at the Department of Urology of JFM CU and UH in Martin during 01/2008 -12/2018. RC and LND were done conventionally in all men and women. Extended LDN was only performed at the advanced stage of the disease or suspected mts to iliac lymph nodes (LU).
Results: Of 128 patients, the primary pathological stage was pT2 105 (82%) and pT1 23 (18%). Cystectomy in pT1 stage was performed in 23 patients after BCG treatment failure and with extensive papillary CA unsuitable for transurethral surgery. In this group, 114 (89.1%) patients had urothelial carcinoma (CA), small cell CA 6 (4.7%), sarcomatoid variant CA 5 (3.9%), urothelial CA with glandular differentiation 2 (1.6%) and with neuroendocrine differentiation 1 (0.8%) patient. In 5 (3.9%) patients, no definitive tumour (pT0) was confirmed in definitive histology, although one of them had histologically verified MTS in LU. Two patients (1.6%) had only carcinoma in situ (CIS) in definitive histology, 11 (8.6%) had pT1, 14 (10.9%) had pT2a, 21 (16.5%) had pT2b, 28 (21.8%) had pT3a, 26 (20.3%) had pT3b and 21 (16.5%) had pT4a pathological stage. 13 (10.2%) patients with advanced disease had only a diversion by ureterocutaneostomy. One (0.8%) patient after salvage cystectomy had a nephrostomy diversion. We performed orthotopic bladder replacement according to Studer in 8 (6.3%) patients and other 106 (82.7%) patients we performed derivation according to Bricker. Four patients (3.1%) died during the postoperative period, two of whom due to embolism to a. pulmonalis and two due to septic shock. Deterioration of ureteroileal anastomosis was observed in 9 (7%) patients, dehiscence of a surgical wound with re-suture 4 (3.1%) patients. Of the 128 patients, 72 (56.3%) had no major complications in the postoperative period. 24 (18.7%) patients were treated with neoadjuvant chemotherapy (two also with radiotherapy), and 56 (43.7%) patients with the advanced disease received adjuvant therapy. Of the 62 patients operated in the 2008-2013 period, 22 (35.4%) survived five years.
Conclusion: RC with pelvic LND is currently considered to be the most effective treatment method in patients with infiltrative bladder tumours with the possibility of complete cure. Due to extensive surgery, the incidence of perioperative and postoperative complications are frequent. Therefore, a thorough preoperative examination with the correct indication as well as the patient’s performance information should not be underestimated.

bladder cancer, radical cystectomy, urinary diversion, complications
Klin urol 2020; 16 (1): 14 – 19

Ročník 2020  Témy časopisu Clinical urology 1 / 2020

Urological oncology

Ján Kliment, Katarína Baluchová, Marián Grendár, Boris Eliáš, Roman Mráz, Peter Čech, Klaudia Holečková, Ján Kliment Jr., Henrieta Drobková
Ján Ľupták, Ján Šulgan, Boris Eliáš, Ján Kliment, sen., Ján Švihra, sen., Ján Kliment jr., Igor Sopilko, Roman Tomaškin, Anna Rašková, Pavol Slávik

Funkcional urology

Magdaléna Hagovská, Ján Švihra, Ján Breza jr., Jozef Dubravický, Marek Vargovčák
Magdaléna Hagovská, Ján Švihra, Ján Breza jr., Jozef Dubravický, Marek Vargovčák
Jozef Marenčák
Michal Kmak

Case studies

Matúš Richnavský, Vincent Nagy, Martin Hrivňák, Ľubomír Lachváč, Andrej Bӧӧr
Vincent Nagy, Hedviga Wagnerová, Dana Nagyová, Helena Baumöhlová
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Nie sú dostupné žiadne voľne dostupné články
CHAIRMAN OF THE EDITORIAL BOARD
prof. MUDr. Ján Kliment, CSc.

MEMBERS OF THE EDITORIAL BOARD
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prof. MUDr. Ján Breza, DrSc.
prof. MUDr. Peter Bujdák, PhD.
prof. MUDr. Tomáš Hanuš, DrSc.
doc. MUDr. Ladislav Jarolím, CSc.
doc. MUDr. Ján Ľupták, PhD.
doc. MUDr. Jozef Marenčák, PhD.
doc. MUDr. Ivan Minčík, PhD.
prof. MUDr. Dalibor Ondruš, DrSc.
prof. Imre Romics, M.D., PhD.
doc. MUDr. Vladimír Študent, PhD.
prof. MUDr. Ján Švihra, PhD.
prof. MUDr. Ladislav Valanský, PhD.
doc. MUDr. František Záťura, PhD.
MUDr. Peter Zvara, PhD.

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Period 3x per year
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The journal is indexed in the Slovak National Bibliography, Bibliographiia Medica Slovaca (BMS) and listed to citation database CiBaMed. All articles are reviewed. The publisher does not bear any responsibility for data and opinions of particular authors of the articles or advertisements. The articles on grey pages are company promotions or non reviewed information, an author is responsible for the content. Any reproduction of the content is allowed only with direct consent of the editorial office.
Predplatné
Clinical urology
Clinical urology
Postgraduate scientific medical journal. Magazine Slovak Association of Urology.
Period 3x per year
Predplatné