PROGNOSTIC FACTORS FOR SURVIVAL IN PATIENTS WITH
INFILTRATIVE BLADDER CANCER TREATED WITH CYSTECTOMY
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
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