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Article published in Urologia Polska 1999/52/2.


Marcin S³ojewski, Andrzej Sikorski
Klinika Urologii Pomorskiej Akademii Medycznej w Szczecinie
Kierownik Kliniki: prof. dr hab. med. A. Sikorski


bladder cancer cystectomy survival


Objective. To evaluate the value of radical cystectomy in treatment of muscle
invasive bladder cancer and to identify the prognostic factors affecting the
Material and method. A multivariate statistical analysis by Cox-Mantel's
proportional hazards model was performed on 95 patients with bladder
carcinoma who undergone cystectomy between 1989 and 1998. Survival curves
were calculated according to Kaplan-Meier techni±ue. Clinicopathological data
included in the analysis were age, stage, grade, nodal involvement, presence of
hydronephrosis and additional treatment used. Median follow-up time was
17.4 months.
Results. Postoperative mortality was 7%. The incidence of positive nodes
rised with increasing pathologic stage: 11%, 21%, 50%, and 51% for pT2, pT3a,
pT3b and pT4 respectively. The probability of 5-year survival (PS) was 44% for
organ-confined tumors (pT2-pT3a) and 11% for tumors with extravesical
invasion (pT3b-pT4). PS for PNo patients was 36% Comparing 5% for those with
nodal involvement (pN+). PS for whole group was 22%. Increased risk of
death was associated with advanced pathological tumor stage pT3b or greater
p = 0. 00002), high grade tumor G3 (p = 0. 01) and positive nodes (p = 0. 0001
Conclusion. The best candidates for cystectomy in terms of survival are
patients with organ-confined £ pT3b, low and medium grade tumors G1-2. Nodal
status has also important influence on survival 2/3 pN+ patients do not survive
more than 1 year. Age and hydronephrosis had no influence on survival after
cystectomy in this material.


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