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 journalArticle

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

Fingerprint

Cystectomy
Frozen Sections
Survival
Ureter
Regression Analysis
Mortality
Carcinoma in Situ
Neoplasms
Logistic Models
Odds Ratio

Keywords

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

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Effect on postoperative survival of the status of distal ureteral margin : The necessity to achieve negative margins at the time of radical cystectomy. / Moschini, Marco; Gallina, Andrea; Freschi, Massimo; Luzzago, Stefano; Fossati, Nicola; Gandaglia, Giorgio; Dell׳oglio, Paolo; Damiano, Rocco; Serretta, Vincenzo; Salonia, Andrea; Montorsi, Francesco; Briganti, Alberto; Colombo, Renzo.

In: Urologic Oncology: Seminars and Original Investigations, Vol. 34, No. 2, 01.02.2016, p. 59.e15-59.e22.

Research output: Contribution to journalArticle

@article{3faa2003f190400f91e124c5cbec9e45,
title = "Effect on postoperative survival of the status of distal ureteral margin: The necessity to achieve negative margins at the time of radical cystectomy",
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",
keywords = "Bladder cancer, Frozen section, Margin, Radical cystectomy, Ureteral margin",
author = "Marco Moschini and Andrea Gallina and Massimo Freschi and Stefano Luzzago and Nicola Fossati and Giorgio Gandaglia and Paolo Dell׳oglio and Rocco Damiano and Vincenzo Serretta and Andrea Salonia and Francesco Montorsi and Alberto Briganti and Renzo Colombo",
year = "2016",
month = "2",
day = "1",
doi = "10.1016/j.urolonc.2015.09.001",
language = "English",
volume = "34",
pages = "59.e15--59.e22",
journal = "Urologic Oncology",
issn = "1078-1439",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Effect on postoperative survival of the status of distal ureteral margin

T2 - The necessity to achieve negative margins at the time of radical cystectomy

AU - Moschini, Marco

AU - Gallina, Andrea

AU - Freschi, Massimo

AU - Luzzago, Stefano

AU - Fossati, Nicola

AU - Gandaglia, Giorgio

AU - Dell׳oglio, Paolo

AU - Damiano, Rocco

AU - Serretta, Vincenzo

AU - Salonia, Andrea

AU - Montorsi, Francesco

AU - Briganti, Alberto

AU - Colombo, Renzo

PY - 2016/2/1

Y1 - 2016/2/1

N2 - 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

AB - 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

KW - Bladder cancer

KW - Frozen section

KW - Margin

KW - Radical cystectomy

KW - Ureteral margin

UR - http://www.scopus.com/inward/record.url?scp=84978472773&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84978472773&partnerID=8YFLogxK

U2 - 10.1016/j.urolonc.2015.09.001

DO - 10.1016/j.urolonc.2015.09.001

M3 - Article

AN - SCOPUS:84978472773

VL - 34

SP - 59.e15-59.e22

JO - Urologic Oncology

JF - Urologic Oncology

SN - 1078-1439

IS - 2

ER -