Outcomes in patients with p0 versus PCIS on final cystectomy pathology.

312 Background: For patients with superficial bladder cancer, the presence of Carcinoma in situ (CIS) is known to increase the risk of subsequent upper tract recurrence. In this study, we focused on patients with no residual invasive carcinoma at cystectomy to determine if those patients with pCIS only on final pathology have worse outcomes than patients with p0 bladders. Methods: We performed a retrospective review of our institutional cystectomy database to identify patients with no residual invasive carcinoma on final pathology (p0 or pCIS only). Chi squared test was used to analyze categorical variables and recurrence rates and the Kaplan-Maier method was used to assess the impact of surgical pathology on recurrence-free survival and overall survival over time. Results: Of the 1,897 cystectomy patients in our institutional database, 630 had no residual invasive carcinoma and had complete follow up data. Of these, 285 had stage p0 and 345 had stage pCIS. Local recurrence, upper tract recurrence, and distant recurrence rates were similar between the two groups (p> 0.05 for all). Disease-specific and overall survival rates were also similar for the two groups. In the subset of patients that had received neoadjuvant chemotherapy, there were also no differences in recurrence and survival rates between the p0 and the pCIS groups. Conclusions: The presence of CIS alone in the cystectomy specimen does not increase risk of upper tract recurrence, distant recurrence, or worsened survival compared to patients with p0 bladder pathology. To note there was no financial funding for this study.

Duke Scholars

Author Vishnukamal Golla Urology