A clinical study on the urethral recurrence of transitional cell carcinoma of bladder following cystectomy

Lee, Jeong Zoo; Yoon, Jong Byung

Abstract

Of 80 male patients who underwent cystectomy. 21 cases received concurrent urethrectomy and 59 cases without urethrectomy. In 59 cases without urethrectomy, urethral recurrence was observed in 6 cases (10.2%). The average period from cystectomy to urethral recurrence was 26.8 months (4-77 months). Early stage A urethral cancer was found in 2 cases and stage B in 4 cases. Histological grade 1 cancer was found in 1 case. grade 2 in 3 cases. and 3 in 2 cases. The proximal end or the urethra was found to be the most frequent site of recurrence with 5 cases exhibiting recurrence at this location and 1 case at distal urethra. Multiplicity of bladder tumor from the trigone to the bladder neck tended to cause recurrence in the urethra. We also assessed for prostatic involvement as well as tumor extent in the bladder. Of the 13 patients with tumor in the prostate, 4 (30.3%) surfered from urethral recurrences. Of the 38 patients with all other types of tumor involvement patterns exclusive of disease in the prostate, only 2(5.3%) had recurrence. We recommend rigorous screening for transitional cell carcinoma of the prostate before and during cystectomy. Prophylactic urethrectomy is indicated for patients with prostatic involvement or in the case of multiple bladder tumor involving trigone and bladder neck.