Long-term Functional and Oncological Outcomes after Radical Cystectomy with Orthotopic Neobladder: A single Institution Study

Background Radical cystectomy (RC) with orthotopic neobladder (ONB) reconstruction provides oncological control and quality-of-life benefits for selected patients with bladder cancer. However, prognostic factors for recurrence remain to be elucidated. Herein, we evaluated oncological outcomes after ONB reconstruction. Methods We retrospectively reviewed 84 patients who underwent RC with ONB reconstruction at our institution between June 2009 and August 2024. We analyzed clinicopathological characteristics, perioperative variables, and postoperative outcomes. Results All patients were male, the median age was 68 ± 7.2 years, and the median follow-up was 79 months (range, 4–179). The 5- and 10-year recurrence-free survival (RFS) rates were 76% and 72%, and the 5- and 10-year cancer-specific survival rates were 92% and 83%, respectively. In univariate analysis, postoperative nodal status, adjuvant chemotherapy, and postoperative T status were significantly associated with RFS. Multivariate analysis identified postoperative T status as the only independent predictor (HR 2.976, 95% CI 1.179–7.5132, p = 0.021).