Retrospective Survival Analysis according to Prognostic Factors after Radical Cystectomy in Bladder Cancer

Lee, Hyun Bo; Lee, Ji Youl; Kim, Sae Woong; Cho, Yong Hyun; Yoon, Moon Soo

Abstract

PURPOSE: Radical cystectomy with pelvic lymphadenectomy is effective therapeutic modality in the management of invasive bladder cancer. We reviewed our experience in order to determine the prognostic factors on survival after radical cystectomy with pelvic lymphadenectomy. MATEIRALS AND METHODS: An analysis was performed of 113 patients with bladder cancer who underwent radical cystectomy with pelvic lymphadenectomy from 1988 to 1997. Ages ranged from 46 to 78-year-old, average age was 61.4+/-9.8 years old. The survival rate according to each factor was calculated by Kaplan-Meier method. Statistics was determined by the log-rank test.
RESULTS
3-year survival rate was 80% in the male patients and 66% in the female patients. Comparing between organ confined(< or =pT3a) and non-organ confined disease(> or =pT3b), 3-year survival rate was 86% for organ confined disease and 34% for non-organ confined disease. 3-year survival rate of the patients with grade I cancer was 96%, grade II cancer 86% and grade III cancer 66%. According to microscopic vascular invasion of the bladder tumor, 3-year survival rate in vascular invasion was 66% and 80% in non-vascular invasion. According to microscopic lymphatic invasion of the bladder tumor, 3-year survival rate was 62% in lymphatic invasion and 88% in non-lymphatic invasion. According to the states of lymph node invasion, 3-year survival rate in the N0 was 84%, in N1 74% and in N2< or = 0%. According to the metastasis, 3-year survival rate in the absence of metastasis was 90%, in nodal invasion 32% and in visceral organ metastasis 26%. There were statistical significant differences in sex, pathologic stage, grade, lymph node invasion and distant metastasis(p<0.05).
CONCLUSIONS
From this study, we think the prognostic factors affecting survival after radical cystectomy with pelvic lymphadenectomy may be sex, pathologic stage, grade, lymph node invasion and distant metastasis. Therefore, careful and more frequent followup is needed in patients with poor prognostic factor.