{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:19:14Z","timestamp":1768004354009,"version":"3.49.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T00:00:00Z","timestamp":1599436800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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\u00a0=\u00a00.015). 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\u00a0=\u00a00.021). A multivariate analysis revealed that performing prophylactic urethrectomy was the only independent predictor of the overall survival rate (P\u00a0=\u00a00.016). In those patients who were treated without neoadjuvant chemotherapy (n\u00a0=\u00a038), the 5-year overall survival rate was significantly higher in the prophylactic urethrectomy group than in the non-prophylactic urethrectomy group (P\u00a0=\u00a00.007).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jjco\/hyaa168","type":"journal-article","created":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T12:02:01Z","timestamp":1597752121000},"page":"287-295","source":"Crossref","is-referenced-by-count":12,"title":["Significance of prophylactic urethrectomy at the time of radical cystectomy for bladder cancer"],"prefix":"10.1093","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7368-4958","authenticated-orcid":false,"given":"Kyohei","family":"Hakozaki","sequence":"first","affiliation":[{"name":"Department of Urology, Keio University School of Medicine, Tokyo, Japan"},{"name":"Department of Urology, National Hospital Organization Saitama National Hospital, Saitama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiji","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Department of Urology, Keio University School of Medicine, Tokyo, Japan"},{"name":"Department of Urology, St. Marianna University School of Medicine, Kanagawa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichiro","family":"Ogihara","sequence":"additional","affiliation":[{"name":"Department of Urology, Keio University School of Medicine, Tokyo, Japan"},{"name":"Department of Urology, Kawasaki Municipal Hospital, Kanagawa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Shigeta","sequence":"additional","affiliation":[{"name":"Department of Urology, Keio University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takayuki","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Clinical and Translational Research Center, Keio University School of Medicine, Tokyo"},{"name":"Yokohama City University, School of Data Science, Kanagawa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasumasa","family":"Miyazaki","sequence":"additional","affiliation":[{"name":"Department of Urology, Saiseikai Yokohamashi Tobu Hospital, Kanagawa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gou","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Urology, Kawasaki Municipal Hospital, Kanagawa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunsuke","family":"Yoshimine","sequence":"additional","affiliation":[{"name":"Department of Urology, Saitama City Hospital, Saitama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunimitsu","family":"Kanai","sequence":"additional","affiliation":[{"name":"Department of Urology, National Hospital Organization Saitama National Hospital, Saitama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Ide","sequence":"additional","affiliation":[{"name":"Department of Urology, Saiseikai Central Hospital, Tokyo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suguru","family":"Shirotake","sequence":"additional","affiliation":[{"name":"Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masafumi","family":"Oyama","sequence":"additional","affiliation":[{"name":"Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1507-1421","authenticated-orcid":false,"given":"Ryuichi","family":"Mizuno","sequence":"additional","affiliation":[{"name":"Department of Urology, Keio University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mototsugu","family":"Oya","sequence":"additional","affiliation":[{"name":"Department of Urology, Keio University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,9,7]]},"reference":[{"key":"2021020810262795300_ref1","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.eururo.2016.09.035","article-title":"Systematic review on the fate of the remnant Urothelium after radical cystectomy","volume":"71","author":"Gakis","year":"2017","journal-title":"Eur Urol"},{"key":"2021020810262795300_ref2","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1016\/j.eururo.2011.08.030","article-title":"Risk factors and outcomes of urethral recurrence following radical cystectomy","volume":"60","author":"Boorjian","year":"2011","journal-title":"Eur Urol"},{"key":"2021020810262795300_ref3","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1097\/01.ju.0000138616.05218.21","article-title":"Urethral recurrence in patients following orthotopic urinary diversion","volume":"172","author":"Hassan","year":"2004","journal-title":"J Urol"},{"key":"2021020810262795300_ref4","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1016\/j.juro.2008.07.039","article-title":"Urethrectomy following cystectomy for bladder cancer in men: practice patterns and impact on survival","volume":"180","author":"Nelles","year":"2008","journal-title":"J Urol"},{"key":"2021020810262795300_ref5","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/S0022-5347(17)50562-5","article-title":"Indications for urethrectomy in men undergoing single stage radical cystectomy for bladder cancer","volume":"131","author":"Ahlering","year":"1984","journal-title":"J Urol"},{"key":"2021020810262795300_ref6","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1016\/S0022-5347(17)38163-6","article-title":"Transitional cell carcinoma of the urethra in men following cystectomy for bladder cancer: multivariate analysis for risk factors","volume":"146","author":"Tobisu","year":"1991","journal-title":"J Urol"},{"key":"2021020810262795300_ref7","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1097\/01.ju.0000149679.56884.0f","article-title":"Urethral tumor recurrence following cystectomy and urinary diversion: clinical and pathological characteristics in 768 male patients","volume":"173","author":"Stein","year":"2005","journal-title":"J Urol"},{"key":"2021020810262795300_ref8","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1159\/000209363","article-title":"The risk factor for urethral recurrence after radical cystectomy in patients with transitional cell carcinoma of the bladder","volume":"82","author":"Cho","year":"2009","journal-title":"Urol Int"},{"key":"2021020810262795300_ref9","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1056\/NEJMoa022148","article-title":"Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer","volume":"349","author":"Grossman","year":"2003","journal-title":"N Engl J Med"},{"key":"2021020810262795300_ref10","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.eururo.2005.04.006","article-title":"Neoadjuvant chemotherapy in invasive bladder cancer: update of a systematic review and meta-analysis of individual patient data advanced bladder cancer (ABC) meta-analysis collaboration","volume":"48","year":"2005","journal-title":"Eur Urol"},{"key":"2021020810262795300_ref11","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1093\/annonc\/mdu126","article-title":"Randomised phase III study of neoadjuvant chemotherapy with methotrexate, doxorubicin, vinblastine and cisplatin followed by radical cystectomy compared with radical cystectomy alone for muscle-invasive bladder cancer: Japan clinical oncology group study JCOG0209","volume":"25","author":"Kitamura","year":"2014","journal-title":"Annals Oncol"},{"key":"2021020810262795300_ref12","doi-asserted-by":"crossref","first-page":"2265","DOI":"10.1002\/(SICI)1097-0258(19981015)17:19<2265::AID-SIM918>3.0.CO;2-B","article-title":"Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group","volume":"17","author":"D'Agostino","year":"1998","journal-title":"Stat Med"},{"key":"2021020810262795300_ref13","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/j.eururo.2006.09.046","article-title":"Prepubic urethrectomy during radical cystoprostatectomy","volume":"51","author":"Joniau","year":"2007","journal-title":"Eur Urol"},{"key":"2021020810262795300_ref14","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/j.urology.2005.09.043","article-title":"Immediate versus staged urethrectomy in patients at high risk of urethral recurrence: is there a benefit to either approach?","volume":"67","author":"Spiess","year":"2006","journal-title":"Urology"},{"key":"2021020810262795300_ref15","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1097\/01.mou.0000170239.02648.6b","article-title":"Short- and long-term issues regarding urethral management in male radical-cystectomy patients","volume":"15","author":"Chang","year":"2005","journal-title":"Curr Opin Urol"},{"key":"2021020810262795300_ref16","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1111\/bju.13370","article-title":"Urethral recurrence after cystectomy: current preventative measures, diagnosis and management","volume":"117","author":"Chan","year":"2016","journal-title":"BJU Int"},{"key":"2021020810262795300_ref17","doi-asserted-by":"crossref","first-page":"e783","DOI":"10.1016\/j.clgc.2017.03.003","article-title":"Effect of urinary cytology for detecting recurrence in remnant Urothelium after radical cystectomy: insights from a 10-year cytology database","volume":"15","author":"Pichler","year":"2017","journal-title":"Clin Genitourin Cancer"},{"key":"2021020810262795300_ref18","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1097\/01.ju.0000135626.91587.c8","article-title":"Treatment of urethral recurrence following radical cystectomy and ileal bladder substitution","volume":"172","author":"Varol","year":"2004","journal-title":"J Urol"},{"key":"2021020810262795300_ref19","doi-asserted-by":"crossref","first-page":"2782","DOI":"10.18632\/oncotarget.23451","article-title":"Risk factors, follow-up, and treatment of urethral recurrence following radical cystectomy and urinary diversion for bladder cancer: a meta-analysis of 9498 patients","volume":"9","author":"Li","year":"2018","journal-title":"Oncotarget"},{"key":"2021020810262795300_ref20","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.acuro.2013.01.005","article-title":"Follow-up after radical cystectomy based on patterns of tumour recurrence and its risk factors","volume":"37","author":"Huguet","year":"2013","journal-title":"Actas Urol Esp"},{"key":"2021020810262795300_ref21","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/S0094-0143(21)00639-X","article-title":"Management of the patient with bladder cancer. Urethral recurrence","volume":"21","author":"Freeman","year":"1994","journal-title":"Urol Clin North Am"},{"key":"2021020810262795300_ref22","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/j.1464-410X.2009.09095.x","article-title":"Management of urethral recurrence after orthotopic urinary diversion","volume":"106","author":"Taylor","year":"2010","journal-title":"BJU Int"},{"key":"2021020810262795300_ref23","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.juro.2015.07.085","article-title":"A multi-institutional analysis of outcomes of patients with clinically node positive Urothelial bladder cancer treated with induction chemotherapy and radical cystectomy","volume":"195","author":"Zargar-Shoshtari","year":"2016","journal-title":"J Urol"},{"key":"2021020810262795300_ref24","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1007\/s12032-014-0421-x","article-title":"Differences in the recurrence pattern after neoadjuvant chemotherapy compared to surgery alone in patients with muscle-invasive bladder cancer","volume":"32","author":"Koie","year":"2015","journal-title":"Med Oncol (Northwood, London England)"},{"key":"2021020810262795300_ref25","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1111\/j.1464-410X.1985.tb05862.x","article-title":"Urethral dysplasia and bladder cancer in cystectomy specimens","volume":"57","author":"Coutts","year":"1985","journal-title":"Br J Urol"},{"key":"2021020810262795300_ref26","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1111\/j.1464-410X.2008.08201.x","article-title":"Prepubic urethrectomy","volume":"103","author":"Van Poppel","year":"2009","journal-title":"BJU Int"}],"container-title":["Japanese Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jjco\/article-pdf\/51\/2\/287\/36212662\/hyaa168.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jjco\/article-pdf\/51\/2\/287\/36212662\/hyaa168.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T20:56:15Z","timestamp":1667854575000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jjco\/article\/51\/2\/287\/5901982"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,7]]},"references-count":26,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,9,7]]},"published-print":{"date-parts":[[2021,2,8]]}},"URL":"https:\/\/doi.org\/10.1093\/jjco\/hyaa168","relation":{},"ISSN":["1465-3621"],"issn-type":[{"value":"1465-3621","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,2]]},"published":{"date-parts":[[2020,9,7]]}}}