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Oncological Outcomes of Radical Cystectomy for Transitional Cell Carcinoma of Bladder

Tanan Bejrananda MD*, Choosak Pripatnanont MD*, Monthira Tanthanuch MD*, Watid Karnjanawanichkul MD*

Affiliation : * Urology unit, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand


Objective : To investigate the oncological outcome of radical cystectomy for muscle invasive bladder (MIBC) on cancer- specific survival. Material and Method: A consecutive series of patients undergoing radical cystectomy from 2004 to 2012 were recorded. The prognostic significance of several clinicopathologic factors in these patients were analyzed. The endpoint of oncological outcome was cancer-specific survival (CSS). The effect of clinical variables on CSS were statistically analysed by a log-rank test or Cox regression with hazard ratios. All analyses were performed using a 0.05 level of significance.
Results : One hundred eleven patients were analyzed. The average patient age when cystectomy was carried out was 65 (35 - 84) years. The 5-year cancer-specific survival rate was 36% for all 111 patients. The 5-year cancers-specific survival rates for patients with clinical T1, T2, T3 and T4 were 89%, 32%, 30% and 11.6%, respectively. Positive lymph nodes were found in 26 patients (23.4%) who had a 5-year cancer-specific survival 12.9%. Of several factors examined, univariate analysis identified tumor stage, nodal status, metastasis, margin positive and lymphovascular invasion (LVI) as significant predictors of OS, of which tumor stage and nodal status appeared to be independently related to overall survival on multivariate analysis.
Conclusion : Radical cystectomy is a standard treatment for muscle invasive bladder cancer. Oncologic outcomes of radical cystectomy is generally favorable, however, surgery alone had no more potential to prolong survival of patients with invasive cancer, multimodal treatment approaches might need.

Keywords : Transitional cell carcinoma of bladder, radical cystectomy, survival, MIBC


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