Clinical outcomes of neobladder or augmentation after cystectomy in locally advanced colorectal cancer involving urinary tract: case series

Background: In most cases of colorectal cancer (CRC) with bladder invasion, ileal conduit (urostomy) is commonly performed. However, with increasing survival rates, quality of life becomes a significant concern, making this approach less favorable. Thus, this study aims to investigate the clinical outcomes of patients with CRC who underwent neobladder or augmentation surgery. Methods: We retrospectively reviewed the records of nine patients who underwent neobladder or augmentation surgery combined with surgical management of locally advanced CRC involving the urinary tract between 2011 and 2018 at Asan Medical Center. Result: Nine patients with rectal or sigmoid colon cancer underwent neobladder or augmentation surgery following total or partial cystectomy. The median operative time was 341 min (range, 208–459 min), and the median urinary tract reconstruction time was 125 min (range, 66–255 min). Early complications occurred in three patients, and one patient experienced a late complication requiring surgical repair. At one year, seven patients achieved full continence without the need for clean intermittent catheterization. With a median follow-up of 56 months, five patients were disease-free, three had persistent disease, and one had died of disease. Conclusion: Quality of life is crucial for CRC patients with improved survival rates. Neobladder or augmentation surgery are feasible options for CRC patients with urinary tract invasion.