Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Apr 29;19(1):28.
doi: 10.1186/s12894-019-0461-9.

Is hysterectomy beneficial in radical cystectomy for female patient with urothelial carcinoma of bladder? A retrospective analysis of consecutive 112 cases from a single institution

Haiwen Huang  1   2 , Bing Yan  3 , Meixia Shang  4 , Libo Liu  1   2 , Han Hao  5   6 , Zhijun Xi  7   8
Affiliations

Is hysterectomy beneficial in radical cystectomy for female patient with urothelial carcinoma of bladder? A retrospective analysis of consecutive 112 cases from a single institution

Haiwen Huang et al. BMC Urol. .

Abstract

Background: There is no criterion for determining whether female patients operated with cystectomy would benefit from hysterectomy. This study compares the oncological outcomes between female patients receiving uterus preserving cystectomy (UPC) and uterus excision cystectomy (UEC).

Methods: Retrospective review of 121 female patients with urothelial carcinoma of bladder undergoing UPC (n = 63) or UEC (n = 49) at a single institute between January 2006 and April 2017. Individual postoperative follow-up plans were performed for patients through outpatient visits. Overall survival (OS) and progression-free survival (PFS) estimates were analyzed using Kaplan-Meier method and multivariable Cox regression.

Results: The median follow-up time was 36 months (interquartile range 16-69). Among patients, 5 (4.1%) had uterus invasion. OS probability (p = 0.939) and PFS probability (p = 0.565) were similar in two groups. In multivariable Cox regression analysis, hysterectomy was not found to be a predictor of OS (hazard ratio 0.908, 95%CI 0.428-1.924, p = 0.801) and PFS (hazard ratio 1.109, 95%CI 0.439-2.805, p = 0.826) after adjusting for age, preoperative clinical stage, pathological stage, pathological nodal stage, neoadjuvant/adjuvant chemotherapy, location of the tumor, and surgical margin. No significant difference of overall survival probability was observed in the patients with organ-confined bladder cancer (p = 0.675) and in patients with no organ-confined bladder cancer (p = 0.695).

Conclusions: The results showed that the rate of uterus invasion was low in patients analyzed in this cohort. It was also found that hysterectomy was not an independent predictor of OS and PFS after radical cystectomy in patients with bladder cancer.

Keywords: Female; Hysterectomy; Radical cystectomy; Urinary bladder neoplasms.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

Present study was approved by the clinical research ethics committee of Peking University First Hospital (Protocol number: 2015[977]), and written informed consent was obtained from all individual participants included in the study.

Consent for publication

Not application.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart of all eligible patients. UPC = uterus preserving cystectomy, UEC = uterus excision cystectomy
Fig. 2
Fig. 2
a Kaplan-Meier curves of overall survival probability in all patients. The 5-years OS were 0.622 vs 0.596 between two groups, and there were no significant differences in the OS probability (p = 0.939). b Kaplan-Meier curves of progression-free survival probability in all patients. The 5-years PFS were 0.777 vs 0.694 between two groups, and there were no significant differences in the PFS probability (p = 0.565). c Kaplan-Meier curves of overall survival probability in organ-confined patients. The 5-years OS were 0.723 vs 0.735 between two groups, and there were no significant differences in the OS probability (p = 0.675). d Kaplan-Meier curves of overall survival probability in no-organ confined patients. The 5-years OS were 0.489 vs 0.469 between two groups, and there were no significant differences in the OS probability (p = 0.695). (UPC = uterus preserved cystectomy, UEC = uterus excision cystectomy)
See this image and copyright information in PMC

References

    1. Antoni S, Ferlay J, Soerjomataram I, Znaor A, Jemal A, Bray F. Bladder Cancer incidence and mortality: a global overview and recent trends. Eur Urol. 2017;71(1):96–108. doi: 10.1016/j.eururo.2016.06.010. - DOI - PubMed
    1. Dobruch J, Daneshmand S, Fisch M, Lotan Y, Noon AP, Resnick MJ, Shariat SF, Zlotta AR, Boorjian SA. Gender and bladder Cancer: a collaborative review of etiology, biology, and outcomes. Eur Urol. 2016;69(2):300–310. doi: 10.1016/j.eururo.2015.08.037. - DOI - PubMed
    1. Stenzl A, Nagele U, Kuczyk M, Sievert K-D, Anastasiadis A, Seibold J, Corvin S. Cystectomy – technical considerations in male and female patients. EAU Updat Ser. 2005;3(3):138–146. doi: 10.1016/j.euus.2005.07.004. - DOI
    1. Weissbart SJ, Smith AL. Hysterectomy in the Urologist’s practice. Curr Urol Rep. 2017;18(1). - PubMed
    1. Gregg JR, Emeruwa C, Wong J, Barocas DA, Chang SS, Clark PE, Cookson MS, Penson DF, Resnick MJ, Scarpato KR, et al. Oncologic outcomes after anterior Exenteration for muscle invasive bladder Cancer in women. J Urol. 2016;196(4):1030–1035. doi: 10.1016/j.juro.2016.04.090. - DOI - PubMed