研究者情報

キクチ　エイジ   KIKUCHI EIJI   菊地栄次    所属   医学部医学科 腎泌尿器外科学    職種   主任教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Significance of prophylactic urethrectomy at the time of radical cystectomy for bladder cancer.
掲載誌名	正式名：Japanese Journal of Clinical Oncology ISSNコード：03682811
掲載区分	国外
巻・号・頁	51(2),287-295頁
著者・共著者	Hakozaki Kyohei, Kikuchi Eiji, Ogihara Koichiro, Shigeta Keisuke, Abe Takayuki, Miyazaki Yasumasa, Kaneko Gou, Maeda Takahiro, Yoshimine Shunsuke, Kanai Kunimitsu, Ide Hiroki, Shirotake Suguru, Oyama Masafumi, Mizuno Ryuichi, Oya Mototsugu.
担当区分	2nd著者,責任著者
発行年月	2021/02
概要	Background: Prophylactic urethrectomy at the time of radical cystectomy is frequently recommended for patients with bladder cancer at a high risk of urethral recurrence without definitive evidence. The present study attempted to clarify the survival benefits of performing prophylactic urethrectomy. Methods: We identified 214 male patients who were treated by radical cystectomy with an incontinent urinary diversion in our seven institutions between 2004 and 2017. We used propensity score matching and ultimately identified 114 patients, 57 of whom underwent prophylactic urethrectomy (prophylactic urethrectomy group) and 57 who did not (non-prophylactic urethrectomy group). Results: No significant differences were observed in the 5-year overall survival rate between the prophylactic urethrectomy and non-prophylactic urethrectomy groups in the overall. However, the local recurrence rate was significantly lower in the prophylactic urethrectomy group than in the non-prophylactic urethrectomy group (P = 0.015). In the subgroup of 58 patients with multiple tumours and/or concomitant carcinoma in situ at the time of transurethral resection of bladder tumour, the 5-year overall survival rate was significantly higher in the prophylactic urethrectomy group than in the non-prophylactic urethrectomy group (P = 0.021). A multivariate analysis revealed that performing prophylactic urethrectomy was the only independent predictor of the overall survival rate (P = 0.016). In those patients who were treated without neoadjuvant chemotherapy (n = 38), the 5-year overall survival rate was significantly higher in the prophylactic urethrectomy group than in the non-prophylactic urethrectomy group (P = 0.007). Conclusions: Prophylactic urethrectomy at the time of radical cystectomy may have a survival benefit in patients with multiple tumours and/or concomitant carcinoma in situ, particularly those who do not receive neoadjuvant chemotherapy.
DOI	doi: 10.1093/jjco/hyaa168
PMID	32893303