ArticleCancers2022
Oncological Outcomes for Patients Harboring Positive Surgical Margins Following Radical Cystectomy for Muscle-Invasive Bladder Cancer: A Retrospective Multicentric Study on Behalf of the YAU Urothelial Group.
Article in Cancers, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Prognostic value of the systemic immune-inflammation index in bladder cancer: an update evidence-based analysis.Frontiers in oncology · 2025Pooled it
- Long-term survival prognosis and risk stratification after radical cystectomy with Mainz Pouch II urinary diversion: a retrospective cohort study and prognostic model construction.Translational andrology and urology · 2026Article
- Prognostic value of tumor budding in muscle-invasive urothelial carcinoma of the bladder.Journal of the Egyptian National Cancer Institute · 2025Article
- The impact of surgery and survival prediction in patients with bladder neuroendocrine carcinoma: a novel propensity score-matched population-based cohort study.European journal of medical research · 2025Article
- Double-J stenting during TURBT increases risk of metachronous upper tract urothelial carcinoma.BMC urology · 2025Article
- The impact of positive surgical margins after cystectomy on oncological outcomes: a nationwide study.BJU international · 2025Article
- Using machine learning for predicting cancer-specific mortality in bladder cancer patients undergoing radical cystectomy: a SEER-based study.BMC cancer · 2025Article
- Treatment Patterns and Radical Cystectomy Outcomes in Patients Diagnosed With Urothelial Nonmetastatic Muscle-Invasive Bladder Cancer in the United States.Cancer medicine · 2025Article
- Explainable multi-modal machine learning for predicting occult pulmonary metastases in differentiated thyroid cancer: a SHAP-based approach prior to radioactive iodine scans.Frontiers in medical technology · 2025Article
- A Systematic Literature Review of Real-World Treatment Effectiveness and Economic and Humanistic Burden in Patients With Muscle-Invasive Bladder Cancer Who Underwent Radical Cystectomy.ClinicoEconomics and outcomes research : CEOR · 2025Review
- Pelvic organ-preserving radical cystectomy versus standard radical cystectomy in female patients diagnosed with bladder cancer.World journal of surgical oncology · 2024Article
- A propensity-score-matched comparison of standard and extended pelvic lymph node dissection in robot-assisted laparoscopic radical cystectomy.Journal of robotic surgery · 2024Article
- Observational
- A Validation Study of cT-Categories in the Swedish National Urinary Bladder Cancer Register-Norrland University Hospital.Journal of personalized medicine · 2023Article
- Prognostic nutritional index combined with NLR to construct a survival prediction model and decision analysis of patients with muscle-invasive bladder cancer after surgery.Cancer medicine · 2023Article
- Singe intraoperative instillation of chemotherapy during radical cystectomy for bladder cancer: Oncological outcome and survival predictors.Cancer medicine · 2023Article
- Optimization of postoperative surveillance protocols in upper tract urothelial cancer: A retrospective cohort study.Frontiers in oncology · 2023Article
- Round up.Indian journal of urology : IJU : journal of the Urological Society of IndiaArticle
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Authors and funding
23 authors at 16 institutions in 10 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Adjuvant therapy has no defined role for patients with positive surgical margins (PSMs) following radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC). The aim of our study was to describe loco-regional recurrence-free survival (LRFS), metastatic-free survival (MFS), recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS) and identify predictors of each endpoint in patients with PSMs following RC for MIBC. Methods: A collaborative retrospective cohort study was conducted on 394 patients with PSMs who underwent RC for MIBC between January 2000 and December 2018 at 10 tertiary referral centers. Patients receiving perioperative radiotherapy were excluded from the study. Kaplan−Meier curves were used to estimate patient survival. Cox regression analysis was used to identify predictors of survival. Results: Median age at surgery was 70 years (IQR 62−76) with 129 (33%) and 204 (52%) patients had pT3 and pT4 tumors, respectively. Nodal metastasis (pN+) was identified in 148 (38%). Soft tissue PSMs were found in 283 (72%) patients, urethral PSMs in 65 (16.5%), and ureteral PSMs were found in 73 (18.5%). The median follow-up time was 44 months (95% CI 32−60). Median LRFS, MRFS, RFS, CSS, and OS were 14 (95% CI 11−17), 12 (95% CI 10−16), 10 (95% CI 8−12), 23 (95% CI 18−33), and 16 months (95% CI 12−19), respectively. On multivariable Cox regression analysis, the pT3−4 stage, pN+ stage, and multifocal PSMs were independent predictors of LRFS, MRFS, RFS, and OS. Adjuvant chemotherapy improved all oncological outcomes studied (p < 0.05). The number of lymph nodes removed was independently associated with better LRFS, MRFS, and RFS. Advanced age at diagnosis was independently associated with worse OS. Conclusion: Patients with PSMs following RC have poor outcomes since half of them will recur within a year and will die of their disease. Among all PSMs types, patients with multifocal PSMs harbor the worst prognosis. We observed a benefit of adjuvant chemotherapy, but clinical trials evaluating innovative adjuvant strategies for these patients remain an unmet need.
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