Long-term Outcomes of Prostate Capsule-Sparing and Nerve-Sparing Radical Cystectomy With Neobladder: A Propensity Score-Matched Comparison
Purpose This study aimed to compare and analyze the feasibility and long-term efficacy of prostatic capsule-sparing (PCS) and nerve-sparing (NS) radical cystectomy in the treatment of bladder cancer. Methods From June 2004 to December 2021, our institution treated and followed 145 patients who under...
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| Format: | Article |
| Language: | English |
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Korean Continence Society
2024-12-01
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| Series: | International Neurourology Journal |
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| Online Access: | http://einj.org/upload/pdf/inj-2448348-174.pdf |
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| author | Zaisheng Zhu Yiyi Zhu Hongqi Shi Penfei Zhou Yadong Xue Shengye Hu |
| author_facet | Zaisheng Zhu Yiyi Zhu Hongqi Shi Penfei Zhou Yadong Xue Shengye Hu |
| author_sort | Zaisheng Zhu |
| collection | DOAJ |
| description | Purpose This study aimed to compare and analyze the feasibility and long-term efficacy of prostatic capsule-sparing (PCS) and nerve-sparing (NS) radical cystectomy in the treatment of bladder cancer. Methods From June 2004 to December 2021, our institution treated and followed 145 patients who underwent radical cystectomy with neobladder reconstruction for over a year. These patients were divided into 2 groups: PCS (n=74) and NS (n=71). To minimize potential biases, 1:1 propensity score matching was utilized to compare oncological outcomes, functional outcomes, and complications between the groups. Additionally, Kaplan-Meier analysis and the log-rank test were used to evaluate survival differences between the PCS and NS groups. Results The median follow-up durations for PCS and NS were 155 and 122 months, respectively. After adjusting for propensity scores, a total of 96 patients (48 in each group) were included for further analysis. Kaplan-Meier curves showed no statistically significant differences in metastasis-free probability (P=0.206), cancer-specific survival (P=0.091), and overall survival (P=0.208). The daytime urinary control (UC) rate at 3, 6, and 12 months postoperatively was 72.9%, 91.7%, and 97.9% in the PCS group and 47.9%, 79.2%, and 91.7% in the NS group, respectively (P=0.012, P=0.083, and P=0.362). The nocturnal UC rate was 54.2%, 85.4%, and 95.8% in the PCS group, and 31.3%, 60.4%, and 83.3% in the NS group, respectively (P=0.023, P=0.006, and P=0.091). Regarding erectile function recovery, 62.5% of patients in the PCS group and 22.9% in the NS group returned to preoperative levels (P<0.001). Conclusions PCS outperformed NS in restoring UC and sexual function and did not affect oncological outcomes. However, PCS was associated with a higher risk of complications linked to bladder-neck obstruction. |
| format | Article |
| id | doaj-art-25bbc242c745408790ed42470cd3c2d2 |
| institution | Kabale University |
| issn | 2093-4777 2093-6931 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Korean Continence Society |
| record_format | Article |
| series | International Neurourology Journal |
| spelling | doaj-art-25bbc242c745408790ed42470cd3c2d22025-08-20T03:41:59ZengKorean Continence SocietyInternational Neurourology Journal2093-47772093-69312024-12-0128427027710.5213/inj.2448348.1741142Long-term Outcomes of Prostate Capsule-Sparing and Nerve-Sparing Radical Cystectomy With Neobladder: A Propensity Score-Matched ComparisonZaisheng Zhu0Yiyi Zhu1Hongqi Shi2Penfei Zhou3Yadong Xue4Shengye Hu5 Department of Urology, Jinhua Hospital Affiliated to Zhejiang University School of Medicine, Jinhua, China Department of Endocrinology, Affiliated Second Hospital to Zhejiang University School of Medicine, Hangzhou, China Department of Urology, Jinhua Hospital Affiliated to Zhejiang University School of Medicine, Jinhua, China Department of Urology, Jinhua Hospital Affiliated to Zhejiang University School of Medicine, Jinhua, China Department of Urology, Jinhua Hospital Affiliated to Zhejiang University School of Medicine, Jinhua, China Department of Urology, Jinhua Hospital Affiliated to Zhejiang University School of Medicine, Jinhua, ChinaPurpose This study aimed to compare and analyze the feasibility and long-term efficacy of prostatic capsule-sparing (PCS) and nerve-sparing (NS) radical cystectomy in the treatment of bladder cancer. Methods From June 2004 to December 2021, our institution treated and followed 145 patients who underwent radical cystectomy with neobladder reconstruction for over a year. These patients were divided into 2 groups: PCS (n=74) and NS (n=71). To minimize potential biases, 1:1 propensity score matching was utilized to compare oncological outcomes, functional outcomes, and complications between the groups. Additionally, Kaplan-Meier analysis and the log-rank test were used to evaluate survival differences between the PCS and NS groups. Results The median follow-up durations for PCS and NS were 155 and 122 months, respectively. After adjusting for propensity scores, a total of 96 patients (48 in each group) were included for further analysis. Kaplan-Meier curves showed no statistically significant differences in metastasis-free probability (P=0.206), cancer-specific survival (P=0.091), and overall survival (P=0.208). The daytime urinary control (UC) rate at 3, 6, and 12 months postoperatively was 72.9%, 91.7%, and 97.9% in the PCS group and 47.9%, 79.2%, and 91.7% in the NS group, respectively (P=0.012, P=0.083, and P=0.362). The nocturnal UC rate was 54.2%, 85.4%, and 95.8% in the PCS group, and 31.3%, 60.4%, and 83.3% in the NS group, respectively (P=0.023, P=0.006, and P=0.091). Regarding erectile function recovery, 62.5% of patients in the PCS group and 22.9% in the NS group returned to preoperative levels (P<0.001). Conclusions PCS outperformed NS in restoring UC and sexual function and did not affect oncological outcomes. However, PCS was associated with a higher risk of complications linked to bladder-neck obstruction.http://einj.org/upload/pdf/inj-2448348-174.pdfurinary bladder neoplasmsradical cystectomyorgan sparing treatmentsfollow-up studiesscoring methods |
| spellingShingle | Zaisheng Zhu Yiyi Zhu Hongqi Shi Penfei Zhou Yadong Xue Shengye Hu Long-term Outcomes of Prostate Capsule-Sparing and Nerve-Sparing Radical Cystectomy With Neobladder: A Propensity Score-Matched Comparison International Neurourology Journal urinary bladder neoplasms radical cystectomy organ sparing treatments follow-up studies scoring methods |
| title | Long-term Outcomes of Prostate Capsule-Sparing and Nerve-Sparing Radical Cystectomy With Neobladder: A Propensity Score-Matched Comparison |
| title_full | Long-term Outcomes of Prostate Capsule-Sparing and Nerve-Sparing Radical Cystectomy With Neobladder: A Propensity Score-Matched Comparison |
| title_fullStr | Long-term Outcomes of Prostate Capsule-Sparing and Nerve-Sparing Radical Cystectomy With Neobladder: A Propensity Score-Matched Comparison |
| title_full_unstemmed | Long-term Outcomes of Prostate Capsule-Sparing and Nerve-Sparing Radical Cystectomy With Neobladder: A Propensity Score-Matched Comparison |
| title_short | Long-term Outcomes of Prostate Capsule-Sparing and Nerve-Sparing Radical Cystectomy With Neobladder: A Propensity Score-Matched Comparison |
| title_sort | long term outcomes of prostate capsule sparing and nerve sparing radical cystectomy with neobladder a propensity score matched comparison |
| topic | urinary bladder neoplasms radical cystectomy organ sparing treatments follow-up studies scoring methods |
| url | http://einj.org/upload/pdf/inj-2448348-174.pdf |
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