Colon Cancer With Bladder Invasion: A Single Center Experience

Abstract

Background/aim: The aim of our study was to investigate the outcome of colon cancer with bladder invasion after surgical intervention.

Patients and methods: Between 2011 and 2022, a total of 41 patients diagnosed with colon cancer and bladder invasion underwent surgical procedures at Taichung Veterans General Hospital. The impact of various risk factors on overall survival (OS) was assessed using Kaplan-Meier analyses and Cox proportional hazards models.

Results: Among the enrolled patients, 21 underwent radical cystectomy, while 20 underwent partial cystectomy. Twelve had tumors located in the rectum, 19 in the sigmoid colon, and 10 in both the rectum and sigmoid colon. The median OS was 71.8 months in stage 2, 50.8 months in stage 3, and 11.2 months in stage 4 (p=0.061). Median OS was 71.8 months in patients with negative surgical margins and 10.5 months in those with positive surgical margins (p=0.003). In multivariate regression analysis, positive surgical margins [hazard ratio (HR)=3.64, 95% confidence interval (CI)=1.28-10.34, p=0.015] and emergency operations (HR=4.57, 95%CI=1.34-15.55, p=0.015) significantly impacted OS.

Conclusion: Complete resection of colon cancer with bladder invasion can yield excellent oncologic outcomes. The decision between partial and radical cystectomy should balance surgical margin clearance and the preservation of quality of life. Both surgical margin involvement and emergency operations are independent risk factors for OS.

Keywords: Colon cancer; bladder invasion; overall survival.

Figure 1

Overall survival and recurrence-free survival between partial cystectomy and radical cystectomy. A) Kaplan-Meier curve comparing overall survival between partial cystectomy and radical cystectomy in patients with colon cancer involving bladder invasion. The median overall survival was 50.8 months in the partial cystectomy group compared to 16.7 months in the radical cystectomy group, p=0.244. B) Kaplan-Meier curve comparing recurrence-free survival between partial cystectomy and radical cystectomy in patients with colon cancer involving bladder invasion. The median recurrence-free survival was non-reached in the partial cystectomy group compared to 5.2 months in the radical cystectomy group, p=0.110.

Figure 2

Overall survival and recurrence-free survival between different pathologic stages. A) Kaplan-Meier curve comparing overall survival among different pathologic stages in patients with colon cancer involving bladder invasion. The median overall survival was 71.8 months in stage 2, 50.8 months in stage 3 and 11.2 months in stage 4, p=0.064. B) Kaplan-Meier curve comparing recurrence-free survival among different pathologic stages in patients with colon cancer involving bladder invasion. The median recurrence-free survival was non-reached in stage 2, 49.6 months in stage 3 and 3.2 months in stage 4, p<0.001.

Figure 3

Overall survival and recurrence-free survival between surgical margin positive and negative. A) Kaplan-Meier curve comparing overall survival among surgical margin positive and negative patients with colon cancer involving bladder invasion. The median overall survival was 71.8 months in the surgical margin negative group and 10.5 months in the surgical margin positive group, p=0.003. B) Kaplan-Meier curve comparing recurrence-free survival between surgical margin positive and negative patients with colon cancer involving bladder invasion. The median recurrence-free survival was non-reached in the surgical margin negative group and 4.7 months in the surgical margin positive group, p=0.003.

Figure 4

Overall survival and recurrence-free survival between different tumor locations. Kaplan-Meier curve comparing overall survival based on different tumor location (rectum, sigmoid or rectum plus sigmoid) in patients with colon cancer involving bladder invasion. The median overall survival was 50.8 months in the sigmoid, 19.7 months in the rectum plus sigmoid and 10.5 months in the rectum, p=0.181. B) Kaplan- Meier curve comparing recurrence-free survival based on different tumor location (rectum, sigmoid or rectum plus sigmoid) in patients with colon cancer involving bladder invasion. The median recurrence free survival was 49.6 months in the sigmoid, non-reached in the rectum plus sigmoid and 4.7 months in the rectum, p=0.112.