Prognostic impact of infiltration of the vagina and/or uterus in women undergoing anterior pelvic exenteration for urothelial carcinoma of the bladder: results of a contemporary multicentre series
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Prognostic impact of infiltration of the vagina and/or uterus in women undergoing anterior pelvic exenteration for urothelial carcinoma of the bladder: results of a contemporary multicentre series. / May, Matthias; Aziz, Atiqullah; Brookman-May, Sabine; Roghmann, Florian; Noldus, Joachim; Rink, Michael; Chun, Felix; Fisch, Margit; Novotny, Vladimir; Wirth, Manfred; Mayr, Roman; Pycha, Armin; Brisuda, Antonin; Volkmer, Björn; Stredele, Regina; Dechet, Christopher; Vallo, Stefan; Haferkamp, Axel; Schnabel, Marco; Denzinger, Stefan; Roigas, Jan; Stief, Christian G; Gilfrich, Christian; Bastian, Patrick J; Engel, Jörg B; Burger, Maximilian; Fritsche, Hans-Martin.
In: WORLD J UROL, Vol. 33, No. 3, 01.03.2014, p. 343-350.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Prognostic impact of infiltration of the vagina and/or uterus in women undergoing anterior pelvic exenteration for urothelial carcinoma of the bladder: results of a contemporary multicentre series
AU - May, Matthias
AU - Aziz, Atiqullah
AU - Brookman-May, Sabine
AU - Roghmann, Florian
AU - Noldus, Joachim
AU - Rink, Michael
AU - Chun, Felix
AU - Fisch, Margit
AU - Novotny, Vladimir
AU - Wirth, Manfred
AU - Mayr, Roman
AU - Pycha, Armin
AU - Brisuda, Antonin
AU - Volkmer, Björn
AU - Stredele, Regina
AU - Dechet, Christopher
AU - Vallo, Stefan
AU - Haferkamp, Axel
AU - Schnabel, Marco
AU - Denzinger, Stefan
AU - Roigas, Jan
AU - Stief, Christian G
AU - Gilfrich, Christian
AU - Bastian, Patrick J
AU - Engel, Jörg B
AU - Burger, Maximilian
AU - Fritsche, Hans-Martin
PY - 2014/3/1
Y1 - 2014/3/1
N2 - PURPOSE: To evaluate for the first time the prognostic significance of female invasive patterns in stage pT4a urothelial carcinoma of the bladder in a large series of women undergoing anterior pelvic exenteration.PATIENTS AND METHODS: Our series comprised of 92 female patients in total of whom 87 with known invasion patterns were eligible for final analysis. Median follow-up for evaluation of cancer-specific mortality (CSM) was 38 months (interquartile ranges, 21-82 months). The impact on CSM was evaluated using multivariable Cox proportional-hazards regression analysis; predictive accuracy (PA) was assessed by receiver operating characteristic analysis.RESULTS: Vaginal invasion was noted in 33 patients (37.9 %; group VAG), uterine invasion in 20 patients (23 %; group UT), and infiltration of both vagina and uterus in 34 patients (39.1 %; group VAG + UT). Groups VAG and UT significantly differed from group VAG + UT with regard to the presence of positive soft tissue margins (STM) only. Five-year-cancer-specific survival probabilities in the groups VAG, UT, and VAG + UT were 21, 20, and 21 %, respectively (p = 0.955). On multivariable analysis, only STM status (HR = 2.02, p = 0.023) independently influenced CSM. C-indices of multivariable models for CSM with and without integration of invasive patterns were 0.570 and 0.567, respectively (PA gain 0.3 %, p = 0.526).CONCLUSIONS: Infiltration of the vagina, the uterus or both is associated with poor 5-year survival rates. With regard to CSM, no difference was detectable between patients with different invasion patterns, thus justifying further collectively including these invasive patterns as stage pT4a.
AB - PURPOSE: To evaluate for the first time the prognostic significance of female invasive patterns in stage pT4a urothelial carcinoma of the bladder in a large series of women undergoing anterior pelvic exenteration.PATIENTS AND METHODS: Our series comprised of 92 female patients in total of whom 87 with known invasion patterns were eligible for final analysis. Median follow-up for evaluation of cancer-specific mortality (CSM) was 38 months (interquartile ranges, 21-82 months). The impact on CSM was evaluated using multivariable Cox proportional-hazards regression analysis; predictive accuracy (PA) was assessed by receiver operating characteristic analysis.RESULTS: Vaginal invasion was noted in 33 patients (37.9 %; group VAG), uterine invasion in 20 patients (23 %; group UT), and infiltration of both vagina and uterus in 34 patients (39.1 %; group VAG + UT). Groups VAG and UT significantly differed from group VAG + UT with regard to the presence of positive soft tissue margins (STM) only. Five-year-cancer-specific survival probabilities in the groups VAG, UT, and VAG + UT were 21, 20, and 21 %, respectively (p = 0.955). On multivariable analysis, only STM status (HR = 2.02, p = 0.023) independently influenced CSM. C-indices of multivariable models for CSM with and without integration of invasive patterns were 0.570 and 0.567, respectively (PA gain 0.3 %, p = 0.526).CONCLUSIONS: Infiltration of the vagina, the uterus or both is associated with poor 5-year survival rates. With regard to CSM, no difference was detectable between patients with different invasion patterns, thus justifying further collectively including these invasive patterns as stage pT4a.
U2 - 10.1007/s00345-014-1308-3
DO - 10.1007/s00345-014-1308-3
M3 - SCORING: Journal article
C2 - 24817140
VL - 33
SP - 343
EP - 350
JO - WORLD J UROL
JF - WORLD J UROL
SN - 0724-4983
IS - 3
ER -