Editing Cystectomy (section)

=== Intraoperative Frozen Sections of the Ureter ===
* '''The distal ureter is involved with tumour on final pathology ≈6-8% at the time of radical cystectomy'''
* '''Intraoperative frozen-section analysis of the ureters at the time of cystectomy remains controversial. Patients with ureteral disease at the time of cystectomy experience an increased risk of upper tract recurrence regardless of margin status, but this risk can be partially mitigated by achieving a negative margin'''
** Final ureteral margin status has proven to be an independent predictor of upper tract recurrence following cystectomy. However, the overall incidence of upper tract recurrence following cystectomy is a relatively rare event ranging from 2-8%.
*** Risk factors for upper tract recurrence following cystectomy:
**** Bladder CIS
**** Distal ureteral involvement with tumor
**** High-grade pTa-T1 disease.
* There is no definitive recommendation for the length of the distal ureter that should be removed at the time of surgery