Oncological and Functional Results of Orthotopic Urine Derivation after Radical Cystectomy on Bladder Cancer

Abstract

Purpose: To evaluate the results of radical cystectomy with orthotopic urine derivation in respect of disease recurrence, survival, as well as early and late complications and quality of life. Materials and methods: the series of 290 bladder cancer patients undergoing radical cystectomy with urine derivation during the period from 1995 to 2011 year were included in our study. The mean patient age was 58.2 (26-87) year. The calculation of the survival rates according to time periods was done using Kaplan-Meier analysis. The quality of life was assessed using modified version of scale MOS-SF-36. Results: the orthotopic urine derivation using intestine was performed in 142 patients with preoperative creatinine level <200 micromoles/l, Hb - at least, 10 g/l and normal preoperative bowel function. The different early postoperative complications were seen in 43.7% patients. The postoperative mortality rate was 4.9% during 1995-1998, 2.1% during 1999-2002, 1.4% during 2003-2006 and 0% from 2007 to 2011 years, respectively. Late complications were found in 27.4%. Local and distant recurrence rates were 7.0% and 15.5%, respectively. The 5-years overall and cancer-specific rates in patients undergoing orthotopic urine derivation was 72% and 83%, respectively. Daily continence was seen in 72.5% patients, while in 44.2% men erectile function was preserved. Summary: Orthotopic urine derivation using intestine segment can be performed in effective and safe fashion, with low complications rate and good long-term functional results.

Keywords

• bladder cancer
• radical cystectomy
• orthotopic urine derivation
• local recurrence
• metastatic disease
• survival
• quality of life