Long Term Outcome of Radical Cystectomy – Monash Medical Centre Experience

1. No. 082 Long Term Outcome of Radical Cystectomy – Monash Medical Centre Experience Emily C Chen, Philip McCahy, SanjeevaRanashinha*, Mark Frydenberg Department of Urology, Southern Health, Victoria, Australia *School of Public Health and Preventive Medicine, Monash University, Victoria, Australia Introduction Bladder cancer is one of the most common genitourinary malignancies, in Australia, over 2000 new cases of bladder cancer were diagnosed each year1. The aggressiveness of this disease mandates an aggressive management with Radical Cystectomy (RC) often advised to optimise survival outcome 2. Results The basic clinicopathological characteristics are detailed in Table 1. 74 patients had  T2 disease. Median time from surgery to last follow up for patients still alive at time of this study was 4.5 years. The overall mortality was high with 69 deaths (70%). The median overall survival was only 2.06 +/- 0.29 years. Overall survival by pathological stage is demonstrated in Graph 1. Table 1 – Basic Clinicopathological characteristics Aim RC has been the preferred treatment for advanced bladder cancer for many years. We present our 10-year experience in RC and report our long term outcome. Methods A total 99 patients between 1998-2008 underwent RC at Monash Medical Centre for primary bladder cancer. Standard en bloc RC with or without lymphadenectomy, and urinary diversion (ileal conduit or orthotopic reconstruction) were performed. Preoperative dichotomous variables and perioperative mortality were recorded. The overall survival outcomes and prognostic factors were analysed. Graph 1 – Overall Survival by Pathological stage Overall Mortality ≈ 70% Estimated 5-year disease specific survival T1 ≈ 36% T2 ≈ 47% T3 ≈ 11% T4 ≈ 0% • Conclusions • The poor survival outcome demonstrated here contrasts markedly with contemporary cystectomy series. Prognostic factors such as tumourclassification, co-morbidities, cell types, advance age, lymph node status were associated with poorer disease specific survival • References • 1 - Australian Cancer Incidence and Mortality – ‘Bladder Cancer – ICD10C67’, 2007 Australian Government. • 2 - StenzlA, Cowan N, Santis M et al. Treatment of Muscle-invasive and Metastatic Bladder Cancer: Update of the EAU Guidelines. European Urology 2011: 59: 1009-1018. Acknowledgements Poster presentation sponsor