title: Long-term followup of all patients with muscle invasive (stages T2, T3 and T4) bladder carcinoma in a geographical region.
abstract: OBJECTIVE
  We studied the relationship between long-term survival and treatment of stages T2, T3 and T4 bladder carcinoma in an unselected patient population.
  
  
  METHODS
  A total of 680 patients with the initial diagnosis of bladder carcinoma in 1987 to 1988 in Western Sweden was prospectively registered and followed until 1994. Of these patients 107 had stage T2 to T3 and 41 had stage T4 disease.
  
  
  RESULTS
  Of the patients with stage T2 to T3 disease 30 (mean age 66) underwent radical cystectomy, 33 (mean age 75) full dose radiotherapy and 44 (mean age 81) nonradical therapy (mainly transurethral resection of the bladder). The 5-year crude survival rates were 33, 15 and 14%, respectively. Of the patients with stage T4 disease 6 (mean age 61) underwent radical cystectomy, 9 (mean age 73) full dose radiotherapy and 26 (mean age 81) nonradical therapy (mainly transurethral resection of the bladder). All except 1 patient died of disease within 4 years.
  
  
  CONCLUSIONS
  More than 60% of the patients in the cohort were considered unsuitable for radical cystectomy and their survival was poor, whether treated with full dose radiotherapy or transurethral resection of the bladder alone.
authors.affiliation: Department of Urology, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Holmäng
authors.forename: H
authors.initials: H
authors.lastname: Hedelin
authors.forename: C
authors.initials: C
authors.lastname: Anderström
authors.forename: S L
authors.initials: SL
authors.lastname: Johansson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011446:Prospective Studies; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000628:therapy