title: Stage B (P2/3A/N0) transitional cell carcinoma of bladder highly curable by radical cystectomy.
abstract: Seventy-one patients with pathologic Stage B (P2/3a/N0) transitional cell carcinoma (TCC) of the bladder underwent radical cystectomy alone without preoperative radiotherapy or perioperative chemotherapy between 1983 and 1987 and have been followed a median of fifty months. The five-year actuarial survival and disease-free survival rates were 82 percent and 77 percent, respectively, and only 13 patients (18%) have relapsed. Histologic parameters were evaluated as to prognostic impact; none correlated with disease-free survival rates although the presence of vessel involvement portended a worse disease-free survival rate (68% versus 80%). During this same period, an additional 15 patients underwent radical cystectomy for pathologic Stage B disease but received adjuvant chemotherapy on the basis of vessel invasion. Their disease-free survival rate at five years was 80 percent, comparable to the disease-free survival rate for patients with vessel invasion treated by surgery alone (68%). Although the role of systemic chemotherapy in the management of invasive bladder cancer remains under investigation, it would appear that patients with Stage B TCC are best treated with radical cystectomy alone. Continued analysis of modern surgical results grouped by current pathologic staging criteria is needed to identify patients who have a relatively low risk of relapse and thus little need for additional therapeutic intervention. These results demonstrate that Stage P2/3a/N0 TCC of the bladder is highly curable by surgery.
authors.affiliation: Department of Urology, University of Texas M.D. Anderson Cancer Center, Houston.
authors.forename: K I
authors.initials: KI
authors.lastname: Wishnow
authors.forename: A K
authors.initials: AK
authors.lastname: Levinson
authors.forename: D E
authors.initials: DE
authors.lastname: Johnson
authors.forename: D M
authors.initials: DM
authors.lastname: Tenney
authors.forename: D J
authors.initials: DJ
authors.lastname: Grignon
authors.forename: J Y
authors.initials: JY
authors.lastname: Ro
authors.forename: A J
authors.initials: AJ
authors.lastname: Ayala
authors.forename: C J
authors.initials: CJ
authors.lastname: Logothetis
authors.forename: D A
authors.initials: DA
authors.lastname: Swanson
authors.forename: R J
authors.initials: RJ
authors.lastname: Babaian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016019:Survival Analysis; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*