Document Detail


Pathological findings of gynecologic organs obtained at female radical cystectomy.
MedLine Citation:
PMID:  12050510     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Historically anterior pelvic exenteration has been the recommended treatment for invasive urothelial carcinoma in women undergoing radical cystectomy. We evaluated the pathological features of reproductive organs removed during exenteration to determine the incidence of malignant pathology in these organs and the need for removal. MATERIALS AND METHODS: We reviewed the records of all patients who underwent radical cystectomy between January 1994 and December 2000. Of these 382 patients, we identified 68 females who underwent radical cystectomy for urothelial carcinoma. We reviewed preoperative, operative and pathological findings, including bladder, lymph nodes, uterine and adnexal pathology, in these female patients. RESULTS: Median patient age was 64 years (range 35 to 86). Gynecologic organs were present in 40 of the 68 surgical specimens (59%). The reasons for absent gynecologic pathology were previous hysterectomy in 26 cases and the preservation of organs during orthotopic urinary diversion creation in 2. Malignancy was identified in 3 specimens, including invasive urothelial carcinoma in 2 (5%). In these 2 cases invasion was clearly identified intraoperatively. Low grade stromal sarcoma of the uterus was present in 1 specimen (2%). CONCLUSIONS: In the absence of clinical suspicion radical hysterectomy at cystectomy rarely improves cancer control. Furthermore, secondary malignancies are rare. The functional impact of preserving gynecologic organs is a subject of ongoing study.
Authors:
Sam S Chang; Emily Cole; Joseph A Smith; Michael S Cookson
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  168     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-06-06     Completed Date:  2002-07-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  147-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Carcinoma, Transitional Cell / pathology,  secondary*,  surgery
Cystectomy*
Endometrial Neoplasms / pathology,  surgery*
Female
Genital Neoplasms, Female / pathology,  secondary*,  surgery
Genitalia, Female / pathology
Humans
Hysterectomy
Middle Aged
Neoplasms, Multiple Primary / pathology,  surgery*
Pelvic Exenteration
Sarcoma, Endometrial Stromal / pathology,  surgery*
Urinary Bladder Neoplasms / pathology,  surgery*
Urinary Reservoirs, Continent*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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