Survival Rates and Prognostic Factors of Transitional Cell Carcinoma of the Bladder Treated by Total Cystectomy

Ahn, Han Jong; Lee, Chongwook

Abstract

Ninety six patients with transitional cell carcinoma of the bladder treated by total cystectomy at Seoul National University Hospital during a 10 year period between 1978 and 1987 were analyzed retrospectively. Four patients were classified in stage pTA, 13 in stage pT1, 4 in stage pTIS, 26 in stage pT2, 19 in stage pT3A, 23 in stage pT3B, and 7 in stage pT4. Eight patients with stage pT3B tumors and 5 patients with stage pT4 tumors had positive pelvic nodes. actuarial 5 year survival rates were 93% for the patients with stage pTA, pT1, and pTIS tumors, 63% for the patients with stage pT2 tumors, 51% for the patients with stage pT3A tumors, 19% for the patients with stage pT3B tumors, and 0% for the patients with stage pT4 tumors. There was no significant difference of survival rate between stage pT2 and pT3A. In 74 patients with stage pT2 or higher tumors, the influence of the tumor grade, shape, size, and number on survival was examined. None of them appeared to be significant. Metastases were found in 45 patients following total cystectomy. Of these, 37 patients (82%) developed metastases within two years of total cystectomy. Thirty patients( 67%) had only distant metastases. 10 patients(22%) had only local recurrence and the remainder had both. The average survival length of the patients with metastases was 9 months. A total cystectomy provided benefit only in the patients with invasive but pathologically bladder confined tumor(pT2, pT3A).