Outcome of Muscle-Invasive Urothelial Bladder XXXX After Radical Cystectomy.

@entity1 @entity5 @entity189 @entity150 @entity3
We aimed at clarification of reasons for recurrence of @entity189 after radical cystectomy in a retrospective study that included 189 @entity1 . Presence of lymphovascular invasion even in node-negative cases, high @entity5 grade, and high nodal stage appeared to be independent predictors for recurrence. This raises the necessity for postoperative multimodality treatment to improve disease-free survival. BACKGROUND: Radical cystectomy remains the gold standard for local control of muscle-invasive @entity150 . Despite that, a significant proportion of @entity1 develop disease recurrence. Several predictors for recurrence have been described and the implication of such factors on development of recurrence will help in modification of treatment strategies to improve the prognosis of @entity150 @entity1 . @entity1 AND METHODS: This is a retrospective study carried on @entity1 with muscle-invasive @entity189 who underwent radical cystectomy at the National @entity5 Institute in 3 years; January 2007 to December 2009, and analyzed for the development of recurrence and potential risk factors. RESULTS: The 3-year disease-free survival (DFS) rate was 56%. Seventy @entity1 (37%) developed disease recurrence during the follow-up period. Of these recurrences, 17 @entity1 (24.3%) developed local and/or regional recurrences, 45 @entity1 (64.3%) developed distant @entity3 , and 8 @entity1 (11.4%) developed local and/or regional and distant recurrences. In univariate analysis, lymph node @entity3 (P < .001), lymphovascular invasion (LVI) (P < .001), high grade (P = .005), and advanced @entity5 stage (P = .002) were significantly associated with development of recurrence. In multivariate analysis, lymph node @entity3 , LVI, and high grade were significantly associated with @entity5 recurrence and poor DFS. CONCLUSION: Lymph node @entity3 , LVI, and high @entity5 grade were independent prognostic factors that affected @entity5 recurrence and DFS. LVI status should be reported in radical cystectomy specimens to help in risk assessment of @entity1 especially in node-negative cases.
