Original ResearchPredictors of female genital organ involvement in radical cystectomy for urothelial carcinoma of the bladder: A single-center retrospective analysis of 112 female patients

•Female patients with muscle invasive bladder cancer are traditionally treated with anterior exenteration.•There was no guideline for female genital organ-sparing surgery in cases to need radical cystectomy.•Tumor location at TUR-B, maximum tumor size or hydronephrosis at CT were predictors for female genital organ involvement.

ObjectivesTo evaluate predictors of organ involvement and oncological outcomes after radical cystectomy with anterior exenteration in female patients.MethodsAmong 1198 patients who underwent radical cystectomy for the bladder tumor between 1990 and 2015, 178 (14.9%) patients were female. They were divided into two groups according to pelvic involvement in pathology. Their medical records and pathology and image findings were reviewed retrospectively. Non-urothelial cell carcinoma and no genital organ pathology were excluded. Multivariate logistic regression was performed to predict factors associated with female organ involvement.ResultsOut of 112 eligible female patients with urothelial cell carcinoma, 11 (9.8%) had female genital organ involvement. Female genital organ involvement occurred primarily in the uterus (63.6%) mostly. The 5-year overall survival rates were 67.3% in the non-involvement group and 18.9% in the involvement group. On multivariate analysis Tumor location of trigone or bladder neck at transurethral resection of bladder tumor (TUR-B) (odds ratio [OR] 19.84, 95% confidence interval [CI] 2.89-230.68, p = 0.0056), maximum tumor size at computed tomography (CT) (OR 2.17, 95% CI 1.29-4.34, p = 0.0095), and hydronephrosis at CT (OR 17.61, 95% CI 2.28-296.26, p = 0.0158) were associated with female organ involvement.ConclusionsTumor location of trigone or bladder neck at TUR-B, maximum tumor size at CT or hydronephrosis at CT were significant factors to predict female genital organ involvement. Preoperative recognition of female genital organ involvement could increase the decision to perform genital organ-sparing surgeries.