Survival after cystectomy for invasive bladder cancer
By: de Vries RR, Nieuwenhuijzen JA, Vincent A, van Tinteren H, Horenblas S.

Department of Urology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
Eur J Surg Oncol. 2010 Jan 22.

Abstract

Aim

To determine the difference in survival after cystectomy between patients presenting with primary muscle infiltrating bladder cancer and patients with progression to muscle infiltration after treatment for initial non−muscle−invasive bladder cancer (NMIBC).

Patients And Methods

We retrospectively analyzed the files of 188 patients who underwent cystectomy for transitional cell carcinoma between 1987 and 2005. Two groups were defined: patients presenting with muscle−invasive tumours and those progressing to muscle invasion after initial treatment. This second group was further divided into low−intermediate and high risk according to the EAU grouping for NMIBC.

Results

The 5−year disease specific survival (95% confidence intervals) for all patients was 50%(42−59%); 49%(40−60%) in the primary muscle infiltrating group and 52%(37−74%) in the progressive group (p = ns). The 5−year disease specific survival in the progressive group according to EAU risk groups was 75%(58−97%) for the initially diagnosed low−intermediate risk tumours and 35%(17−71%) for the initially diagnosed high−risk tumours (p = 0.015). The percentage of patients with non−locally confined tumours (pT3/4−N0//any pT−N+) was 31%//45% and 24%//46% in the primary muscle infiltrating and progressive group, respectively.

Conclusions

Despite close observation of patients treated for non−muscle−invasive bladder cancer, the survival of patients who progress to muscle invasion is not better than survival of patients presenting with primary muscle infiltrating cancer. Patients with high−risk non−invasive tumours (EAU risk−categories) who progress to muscle−invasive disease have a worse prognosis compared to patients with low or intermediate risk tumours. Copyright © 2009 Elsevier Ltd. All rights reserved.

PMID: 20097512 [PubMed − as supplied by publisher] Source: National Library of Medicine.






* Albert Einstein College of Medicine has been
awarded Acceditation with Commendation by
the ACCME

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