TY - JOUR
T1 - Radical Cystectomy in the Treatment of Bladder Cancer
T2 - Oncological Outcome and Survival Predictors
AU - Ho, Chen Hsun
AU - Huang, Chao Yuan
AU - Lin, Wei Chou
AU - Chueh, Shih Chieh
AU - Pu, Yeong Shiau
AU - Lai, Ming Kuen
AU - Yu, Hong Jeng
AU - Huang, Kuo How
PY - 2009/11/1
Y1 - 2009/11/1
N2 - Background/Purpose: To better understand the result of radical cystectomy in the treatment of bladder cancer, we analyzed our data and reported the oncological outcomes and survival predictors. Methods: Patients underwent radical cystectomy for bladder transitional cell carcinoma between March 1995 and July 2007 were evaluated. The clinical course, pathological characteristics, and clinical outcomes were described and analyzed. Results: A total of 148 patients (98 men and 50 women) with a median age of 66.7 years (range: 23.8-83.3) were included in the study. Median follow-up was 64 months. The perioperative mortality was 2.7%. The 5-year recurrence-free survival (RFS) and overall survival (OS) for all 148 patients was 61% and 53%, respectively. The 5-year RFS and OS were 68% and 62% for pT2, 65% and 59% for pT3, 11% and 9% for pT4, and 37% and 31% for nodal-positive disease, respectively. The number of positive lymph nodes was significantly associated with survival: 5-year RFS and OS were 54% and 33%, for patients with only 1-3 positive lymph nodes, whereas, all patients with ≥4 positive lymph nodes had recurrence. On multivariate analysis, age > 60 years, pT4 tumors, and lymph node involvement had a negative impact on survival. Conclusion: Radical cystectomy can be curative in a significant portion of patients with organ-confined (T2 or less) and extravesical (pT3) bladder cancer. Age > 60 years, pT4 tumors, and nodal metastases were associated with poor prognosis. Patients with limited lymph node involvement (1-3 nodes) can be cured by surgery alone, whereas a more extensive lymph node metastasis (≥ 4 nodes) eventually results in recurrence. Concomitant prostate cancer is of low grade and early stage, and is clinically insignificant.
AB - Background/Purpose: To better understand the result of radical cystectomy in the treatment of bladder cancer, we analyzed our data and reported the oncological outcomes and survival predictors. Methods: Patients underwent radical cystectomy for bladder transitional cell carcinoma between March 1995 and July 2007 were evaluated. The clinical course, pathological characteristics, and clinical outcomes were described and analyzed. Results: A total of 148 patients (98 men and 50 women) with a median age of 66.7 years (range: 23.8-83.3) were included in the study. Median follow-up was 64 months. The perioperative mortality was 2.7%. The 5-year recurrence-free survival (RFS) and overall survival (OS) for all 148 patients was 61% and 53%, respectively. The 5-year RFS and OS were 68% and 62% for pT2, 65% and 59% for pT3, 11% and 9% for pT4, and 37% and 31% for nodal-positive disease, respectively. The number of positive lymph nodes was significantly associated with survival: 5-year RFS and OS were 54% and 33%, for patients with only 1-3 positive lymph nodes, whereas, all patients with ≥4 positive lymph nodes had recurrence. On multivariate analysis, age > 60 years, pT4 tumors, and lymph node involvement had a negative impact on survival. Conclusion: Radical cystectomy can be curative in a significant portion of patients with organ-confined (T2 or less) and extravesical (pT3) bladder cancer. Age > 60 years, pT4 tumors, and nodal metastases were associated with poor prognosis. Patients with limited lymph node involvement (1-3 nodes) can be cured by surgery alone, whereas a more extensive lymph node metastasis (≥ 4 nodes) eventually results in recurrence. Concomitant prostate cancer is of low grade and early stage, and is clinically insignificant.
KW - bladder cancer
KW - cystectomy
KW - lymph nodes
KW - neoplasm metastasis
KW - survival
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U2 - 10.1016/S0929-6646(09)60419-8
DO - 10.1016/S0929-6646(09)60419-8
M3 - Article
C2 - 19933031
AN - SCOPUS:71649087105
SN - 0929-6646
VL - 108
SP - 872
EP - 878
JO - Journal of the Formosan Medical Association
JF - Journal of the Formosan Medical Association
IS - 11
ER -