The following is a summary of “Oncological and functional outcomes of female reproductive organ-sparing radical cystectomy and ileal neobladder construction,” published in the May 2023 issue of the Urologic Oncology by Miura et al.
The objective is to examine the oncological and urinary functional outcomes of ROS-RC and U-shaped ileal neobladder construction in female versus male patients. Between May 1996 and July 2021, researchers retrospectively examined 357 patients (281 men and 76 women) with muscle-invasive bladder cancer treated with RC + U-shaped ileal neobladder construction. All female patients received ROS-RC treatment.
They compared male and female patients’ disease-free survival, cancer-specific survival, overall survival, and urinary functional outcomes. They analyzed the gender effect on DFS, CSS, and OS. In addition, a pressure-flow study evaluated practical urinary results in 140 males and 48 females 3, 6, 9, and 12 months after surgery. During radical cystectomy, female patients were significantly older than male patients. There was no significant difference in the preoperative tumor stage. The multivariable Cox regression analysis using an inverse probability treatment weighted model revealed no significant association between female gender and DFS, CSS, and OS.
In addition, at 12 months, males and females had comparable urinary functions, except for the capacity of the neobladder, detrusor pressure, and maximal urethral closure pressure. This study demonstrates that ROS-RC and U-shaped ileal neobladder construction are not substantially associated with poorer oncological outcomes in female patients. ROS-RC and U-shaped ileal neobladder construction could achieve adequate urinary function without compromising oncologic outcomes.