{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T10:27:58Z","timestamp":1787308078118,"version":"build-2736575974"},"reference-count":27,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Radical cystectomy (RC) is standard treatment for muscle-invasive bladder cancer, but the role of gynecologic organ preservation in women remains uncertain. We primarily evaluated the prevalence and predictors of pathological gynecologic organ involvement and secondarily assessed survival and developed a prediction model. Materials and Methods: This multicenter retrospective study included 232 women undergoing RC at 13 tertiary centers. Of the 232 women, 182 had clinical T2 disease and 50 had BCG-unresponsive or very-high-risk Ta\/T1 non-muscle-invasive bladder cancer. Overall survival (OS) was the primary endpoint; CSS and RFS were secondary outcomes. Multivariable logistic regression was used to identify predictors and develop preoperative prediction models. Results: Pathological gynecologic organ involvement was identified in 26 patients (11.2%): uterine in 15 (6.5%), vaginal in 11 (4.7%), ovarian in five (2.2%), and adnexal in 21 (9.1%). The median OS was shorter in patients with involvement than in those without (19.0 vs. 48.0 months; p = 0.048). Vaginal and ovarian involvement were associated with shorter OS (both p &lt; 0.001), whereas uterine and adnexal involvement were not. Pathological T stage was associated with organ involvement (p = 0.001), with the highest frequency in pT4 disease. Model 2 showed an AUC of 0.898 and an optimism-corrected AUC of 0.872. A risk score of 0 classified 31.0% as low risk, with an NPV of 97.2% and a sensitivity of 92.3%. Conclusions: Pathological gynecologic organ involvement was uncommon but associated with poorer survival. These findings may support preoperative risk stratification, although the oncologic safety of organ-preserving surgery cannot be established from pathological involvement data alone.<\/jats:p>","DOI":"10.3390\/medicina62081609","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T09:31:59Z","timestamp":1787304719000},"page":"1609","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes\u00a0and Predictive Factors for Gynecologic Organ Involvement in Radical Cystectomy for Female Bladder Cancer Patients: A Multicenter Retrospective Cohort Study"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9707-596X","authenticated-orcid":false,"given":"Mehmet G\u00fcrkan","family":"Arikan","sequence":"first","affiliation":[{"name":"Department of Urology, School of Medicine, \u00c7ukurova University, Adana 01330, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ersan","family":"Arda","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Trakya University, Edirne 22030, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volkan","family":"\u0130zol","sequence":"additional","affiliation":[{"name":"Department of Urology, \u00c7ukurova Urology Center, Adana 01170, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasan","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Kocaeli University, Kocaeli 41001, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4093-5436","authenticated-orcid":false,"given":"Evren","family":"Suer","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Ankara University, Ankara 06230, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"Akgul","sequence":"additional","affiliation":[{"name":"Department of Urology, \u00dcmraniye Training and Research Hospital, University of Health Sciences, Istanbul 34668, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9616-3776","authenticated-orcid":false,"given":"Sertac","family":"Yazici","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Hacettepe University, Ankara 06800, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7338-8737","authenticated-orcid":false,"given":"Deniz","family":"Bolat","sequence":"additional","affiliation":[{"name":"Department of Urology, \u0130zmir City Hospital, \u0130zmir 35540, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guven","family":"Aslan","sequence":"additional","affiliation":[{"name":"Department of Urology, School of Medicine, Dokuz Eyl\u00fcl University, \u0130zmir 35220, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serkan","family":"Akan","sequence":"additional","affiliation":[{"name":"Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, Istanbul 34752, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Levent","family":"Turkeri","sequence":"additional","affiliation":[{"name":"Department of Urology, Ac\u0131badem Mehmet Ali Ayd\u0131nlar University Hospital, Istanbul 34638, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1038\/s41571-023-00744-3","article-title":"Global trends in the epidemiology of bladder cancer: Challenges for public health and clinical practice","volume":"20","author":"Vrieling","year":"2023","journal-title":"Nat. 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