Clinical and pathological factors associated with recurrence after radical cystectomy for bladder cancer: A single-center retrospective study

Abstract

Background and Objective: Radical cystectomy (RC) is standard treatment for muscle-invasive bladder cancer (MIBC); however, disease recurrence remains a major challenge. This study aimed to describe recurrence patterns and explore clinical and pathological factors associated with early recurrence post-RC.

Methodology: This retrospective cohort study included adult patients with histologically confirmed bladder cancer who underwent RC at the Pakistan Kidney and Liver Institute & Research Center, Lahore, between February 2023 and August 2025. Demographic, pathological, treatment, and follow-up data were extracted. Recurrence status was available for 40 patients and was analyzed using descriptive statistics and univariate analyses.

Results: Among 70 patients, follow-up sufficient to evaluate recurrence was available for 40 (57.1%). Recurrence occurred in nine patients (9/40, 22.5%) during the available follow-up period. Mean time to recurrence among affected patients was 5.0 ± 2.7 months. Histological subtype showed a possible signal with recurrence, with squamous cell carcinoma appearing more frequently among recurrence cases (p = 0.019); however, this observation was based on a very small number of patients and should be interpreted with caution. Other demographic, tumor-related, and treatment variables were not significantly associated with recurrence. Follow-up duration was varied and shorter among recurrence cases compared with non-recurrence cases, which may establish detection bias.

Conclusion: In this single-center cohort, early recurrence after radical cystectomy was observed in a subset of patients; however, the small sample size, short follow-up duration, and substantial loss to follow-up limit reliable identification of predictors. Larger prospective studies are needed to characterize recurrence patterns post-RC.