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19–22 APRIL, 2017, BARCELONA, SPAIN
08:20–08:23
S13-5 (PP)
PROGNOSIS AND NATURAL HISTORY OF MALIGNANCY
AFTER AUGMENTATION ENTEROCYSTOPLASTY:
A MULTICENTER REPORT
Sarah GARNIER
1
, Bernard BOILLOT
2
, Gilles KARSENTY
3
, Jean Michel GUYS
4
,
Thomas BLANC
5
, Stephen LORTAT JACOB
6
, Laurent SOUSTELLE
7
, Veronique PHE
8
,
Alexia EVEN
9
, Emmanuel CHARTIER KASSLER
8
, Gregoire POINAS
10
,
Pierre COSTA
11
, Francois IBORRA
12
, Xavier GAME
13
and Nicolas KALFA
14
1) Hôpital Lapeyronie, CHU de Montpellier, Service de Chirurgie et Urologie Pédiatrique, Montpellier, FRANCE - 2) CHU
de Grenoble, Service d’urologie et de la transplantation rénale, La Tronche, FRANCE - 3) CHU MARSEILLE,
Hôpital la Conception, Service d’Urologie et de Transplantation Rénale, Marseille, FRANCE - 4) CHU MARSEILLE,
Hôpital la TIMONE, Service de Chirurgie et Urologie Pédiatrique, Marseille Cedex 5, FRANCE - 5) Hopital Necker
Enfants Malades, Service de Chirurgie Viscérale et Urologie Pédiatrique, Paris Cedex 15, FRANCE - 6) Service de
Chirurgie Viscérale et Urologique Pédiatrique, Hopital Necker Enfants Malades, Paris Cedex 15, FRANCE - 7) Hôpital
Universitaire Carémeau, Service d’Urologie, Nimes Cedex 9, FRANCE - 8) Hôpital Pitié-Salpêtrière, Service d’Urologie,
Paris, FRANCE - 9) Hopital Raymond Pointcare, Service d’Urologie, Garches, FRANCE - 10) Clinique Beau Soleil,
Service d’Urologie, Montpellier, FRANCE - 11) CHU Nimes, Service D’urologie, Nimes Cedex 9, FRANCE - 12) Hôpital
Lapeyronie, CHU de Montpellier, Service d’Urologie et de Transplantation Rénale, Montpellier, FRANCE - 13) CHU
Rangueil, Département d’Urologie, Toulouse, FRANCE - 14) Service de Chirurgie Viscérale et Urologique Pédiatrique,
Hôpital Lapeyronie, CHU de Montpellier, Montpellier, FRANCE
PURPOSE
Limited data on malignancy after augmentation enterocystoplasty have been reported since it
remains rare with a long latency period. The aim of this study is to describe the natural history of
these tumours based on the largest series of patients to date.
MATERIAL AND METHODS
A multicenter nationwide retrospective study included 14 patients based on operative, oncologic
and anatomopathological reports.
RESULTS
Ileum (36%), stomach (36%), colon (21%) and ileo-colon (7%) were used for enterocystoplasty.
The mean latency period was 20 years (5-37). Only 14% of patients were diagnosed before clinical
manifestations (haematuria, hydronephrosis, fistula). Three patients underwent systematic endos-
copy but only one was diagnosed this way. Histology showed adenocarcinomas (43%), urothelial-
cell (29%), squamous-cell (21%) and undifferentiated (7%) carcinomas. 80% of gastrocystoplasties
led to adenocarcinomas while urothelial-cell carcinoma was typically found after colocystoplasties.
Localization of malignancies was mainly on the bowel segment (64%), native bladder (36%) and the
entero-urinary anastomosis (21%). The vast majority of patients were diagnosed at an advanced
stage (metastases :50%, positive lymph-nodes :36%). Urinary tract infections were statistically
associated (p=0,02) with initial metastatic status but lithiasis, intermittent catheterism, immunosup-
pression and tumour localization were not. Survival rates were 50% after one year and 29% at the
end of the study. Only 2 patients are disease-free with a median follow-up of 59 months (20-89).
CONCLUSIONS
Malignancy after enterocystoplasty is lately diagnosed with frequent metastases and low 1-year
survival rate. The entero-urinary anastomosis is not the main localization of tumours. Systematic
endoscopy is not widely used and its efficiency may be limited. The knowledge of the natural history
of these tumours may lead to improved screening and management.