This study aimed to identify the risk factors impacting long-term outcomes in patients diagnosed with sigmoid
colon cancer with urinary bladder involvement.

A comprehensive analysis was conducted on a retrospective cohort of 118 patients who underwent multivisceral
resection for sigmoid colon cancer with urinary bladder involvement between June 2002 and May 2017. Univariate and
multivariate analyses were employed to identify risk factors associated with long-term outcomes.
Results Among the included patients, 10 (8.5%) experienced grade III-IV complications according to Clavien-Dindo classification,
with 4 (3.4%) presenting anastomotic leaks. The postoperative mortality was 0.8%. R0 resection was achieved in
108 (91.6%) patients. Adjuvant chemotherapy was administrated to only 31 patient (26.3%). Local recurrence was observed in
8 (6.8%) cases. Risk factors for local recurrence-free survival and disease-free survival were CCI>3, grade III–IV postoperative
complications according to Clavien-Dindo classification, positive resection margins, stage III of the disease, additional
resected organs (excluding colon and bladder) and the absence of adjuvant chemotherapy. The same risk factors, with the
exception of CCI, were associated with overall survival.

This study highlights that negative resection margins, a postoperative period without grade III-IV complications,
and the implementation of adjuvant chemotherapy are crucial factors contributing to improve overall, disease-free and local
recurrence-free survival in patients with sigmoid colon cancer with urinary bladder involvement.