Effect on postoperative survival of the status of distal ureteral margin: The necessity to achieve negative margins at the time of radical cystectomy

Marco Moschini, Andrea Gallina, Massimo Freschi, Stefano Luzzago, Nicola Fossati, Giorgio Gandaglia, Paolo Dell׳oglio, Rocco Damiano, Vincenzo Serretta, Andrea Salonia, Francesco Montorsi, Alberto Briganti, Renzo Colombo

Research output: Contribution to journalArticlepeer-review

Abstract

Background Despite several studies, the adequate management of positive distal ureter margins at the time of radical cystectomy (RC) remains controversial. Particularly, it is not clear whether the achievement of negative distal ureter margins at the intraoperative frozen sections (IFS) affects postoperative cancer-specific mortality (CSM). Methods In all, 1,447 consecutive patients treated with RC at a single center between January 1987 and August 2014 were considered. Multivariable (MVA) logistic regression analyses were used to determine predictors of positive IFS. MVA Cox regression analyses were used to test the effect on CSM of intraoperative conversion to negative margins. Results At IFS, 368 patients (25%) experienced at least 1 positive margin. Of these, a negative conversion of the margin at IFS occurred in 178 (48%) whereas 190 (52%) had a positive final ureteral margin. The mean follow-up was 95 months (median = 102). At MVA, history of carcinoma in situ (odds ratio = 6.40, P

Original languageEnglish
Pages (from-to)59.e15-59.e22
JournalUrologic Oncology: Seminars and Original Investigations
Volume34
Issue number2
DOIs
Publication statusPublished - Feb 1 2016

Keywords

  • Bladder cancer
  • Frozen section
  • Margin
  • Radical cystectomy
  • Ureteral margin

ASJC Scopus subject areas

  • Oncology
  • Urology

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