Radical Cystectomy is indicated in muscle-invasive bladder cancer and select cases of nonmuscle invasive bladder cancer. Women often undergo additional reproductive organ removal, greatly impacting sexual function and quality of life. Pelvic organ-preserving radical cystectomy aims to mitigate these effects, but its oncologic outcomes are not well-defined. This presents a meta-analysis of available literature on oncological outcomes of pelvic organ-preserving radical cystectomy in women with muscle invasive disease.
A systematic search across PubMed, Web of Science, Scopus, and Google Scholar was performed to identify studies comparing oncological outcomes between pelvic organ-preserving radical cystectomy and standard radical cystectomy in women with muscle-invasive bladder cancer or high-risk or recurrent nonmuscle invasive cancer. The search included English or Spanish studies, statistically comparing overall survival, cancer-specific survival, and recurrence-free survival. Statistical analysis used Review Manager, employing fixed or random-effects models based on heterogeneity.
Six retrospective studies met inclusion criteria, totaling 597 patients of which 303 received pelvic organ-preserving radical cystectomy and 294 received standard radical cystectomy. Overall Survival was not different between the 2 groups (HR 1.05 [0.77, 1.43]; P = 0.77). Cancer-Specific Survival also was found to be not different between the 2 groups (HR 1.27 [0.86, 1.87]; P = 0.22). Additionally, recurrence-free survival was not different between the 2 groups (HR 0.85 [0.41, 1.75]; P = 0.65. Four of the included studies exhibited a moderate risk of bias, with 1 study demonstrating low risk and the remaining study manifesting a serious risk of bias.
The comparison showed no significant differences in overall survival, cancer-specific survival, or recurrence-free survival rates.
Urologic oncology. 2024 Oct 11 [Epub ahead of print]
David E Hinojosa-Gonzalez, Gal Saffati, Eric Wahlstedt, Madeline Chaput, Sagar R Patel, Gustavo Salgado-Garza, Shane Kronstedt, Michal R Segall, Juan C Angulo-Lozano, Jeffrey A Jones, Jennifer M Taylor, Jeremy R Slawin
Scott Department of Urology, Baylor College of Medicine, Houston, TX., University of Kentucky College of Medicine, Lexington, KY., Oregon Health and Sciences University, Portland, OR., Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Department of Urology, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY., Scott Department of Urology, Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center, Houston, TX., Scott Department of Urology, Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center, Houston, TX. Electronic address: .