title: [Prognostic value of tumor location of urothelial tumors of the bladder, after total cystectomy].
abstract: OBJECTIVE
  Comparison of the various treatment protocols for bladder cancer requires identification of survival prognostic factors. Some clinical parameters, such as tumour sub-site, have still not been studied. The authors therefore analysed the prognostic value of this factor, in combination with known prognostic factors, after radical cystectomy for urothelial bladder tumour.
  
  
  METHODS
  120 patients were treated for pure urothelial bladder tumour with pelvic lymphadenectomy, between January 1980 and January 1999, in a single centre. The prognostic value of the various sub-sites was studied by univariate and multivariate survival analysis.
  
  
  RESULTS
  The 5-year survival decreased from 62% to 19% in the case of a lesion involving the bladder dome (p = 0.0001). Multivariate analysis demonstrated the following independent prognostic factors: local invasion pT < or = 3 (p = 0.003), lymph node involvement (p = 0.05) and involvement of the dome (p = 0.002). Other tumour sub-sites had an effect on survival on univariate analysis that was not confirmed on multivariate analysis.
  
  
  CONCLUSIONS
  Although stages pT and pN are prognostic factors recognized by all studies, invasion of the bladder dome appears to have a major independent influence on survival. This result must be confirmed by other studies, in view of its potential influence for determination of homogeneous patient groups in controlled trials.
authors.affiliation: Service d'Urologie, Centre Hospitalier Universitaire de Besançon, 2, place Saint-Jacques, 25030 Besançon. CMMintl@club-internet.fr
authors.forename: Mael
authors.initials: M
authors.lastname: Martin
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bernardini
authors.forename: François
authors.initials: F
authors.lastname: Kleinclauss
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Della Negra
authors.forename: Pierre Charles
authors.initials: PC
authors.lastname: Henry
authors.forename: Hugues
authors.initials: H
authors.lastname: Bittard
mesh_terms: D000328:Adult; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015653:Cystectomy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*