Local recurrence after cystectomy and survival of patients with bladder cancer: a population based study in greater amsterdam.
OBJECTIVE
We determined retrospectively in a population based study the survival of patients with bladder cancer and the local recurrence rate (LRR) after cystectomy.


METHODS
All patients with bladder cancer diagnosed between 1988 and 2001 (vital status updated until September 2003) were selected from the Amsterdam Cancer Registry, which covers a population of 2.84 million individuals. For all patients who underwent cystectomy between 1988 and 1997 at 18 participating hospitals information on local recurrence and vital status was collected from the medical records.


RESULTS
Five-year relative survival in all 8,321 bladder cancer cases combined was 75%. For clinical stage 0-a this was 99%, decreasing to 85% for stage 0-is and 82% for stage I, and to 44%, 28% and 9% for stages II to IV, respectively. Five-year relative survival after cystectomy was 81%, 44% and 23% for stages II to IV, respectively. The LRR after cystectomy was 19% in all 566 cases and all institutions combined. The LRR increased with higher pT stage and it achieved 11%, 23% and 31% for stages II to IV, respectively. It was slightly lower at oncological centers than at community hospitals (18% vs 20%, not significant).


CONCLUSIONS
Survival is higher than the European average but below the value in the United States. Only 1 of 3 stages II-III cases was treated with cystectomy. Relatively high stage specific survival is experienced after cystectomy despite local recurrence in 1 of 5 patients.
Visser
O
O
Comprehensive Cancer Centre Amsterdam and Department of Urology, Netherlands Cancer Institute (JAN, SH), Amsterdam, The Netherlands. o.visser@ikca.nl
Nieuwenhuijzen
J A
JA
Horenblas
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D015653:Cystectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009426:Netherlands; D012189:Retrospective Studies; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000401:mortality* / Q000601:surgery*