title: Analysis of prognostic factors in patients with transitional cell carcinoma of the bladder treated with radical cystectomy.
abstract: OBJECTIVE
  To analyze the results of the treatment of transitional cell carcinoma (TCC) of the bladder with radical cystectomy and determine which prognostic factors can be utilized as disease-free survival and cancer-specific survival independent variables.
  
  
  METHODS
  Medical records of 113 patients submitted to radical cystectomy and bilateral iliac lymphadenectomy between 1993 and 2005 were reviewed. The risk factors analyzed were age, sex, pathological stage, tumor grade, presence of carcinoma in situ and the presence of lymph nodes involvement.
  
  
  RESULTS
  After a mean follow-up of 31.7 +/- 28.5 months, 46 patients (40.7%) presented recurrence and 24 patients (21.2%) died due to cancer. Only pathological stage and the lymph nodes involvement became independent variables for recurrence and survival. Patients with T4 stage presented 9.6 times the risk of recurrence of the disease when compared with stage T0 patients (p = 0.010) and the patients with lymph node involvement presented 2.5 times the risk of recurrence (p = 0.047) and 3.1 times the risk of death (p = 0.022) when compared to patients without lymph nodes involvement.
  
  
  CONCLUSIONS
  Pathological stage and the involvement of lymph nodes represented more important prognostic variables, and in the presence of advanced stage tumors (T3/T4) and involvement of lymph nodes, the institution of adjuvant treatment should be considered.
authors.affiliation: Department of Urology, University of Sao Paulo, Sao Paulo, Brazil. aantunes_uro@yahoo.com
authors.forename: Alberto A
authors.initials: AA
authors.lastname: Antunes
authors.forename: Luciano J
authors.initials: LJ
authors.lastname: Nesrallah
authors.forename: Marcos F
authors.initials: MF
authors.lastname: Dall'Oglio
authors.forename: Yuri A
authors.initials: YA
authors.lastname: Ferreira
authors.forename: Carlo C
authors.initials: CC
authors.lastname: Passerotti
authors.forename: Katia R
authors.initials: KR
authors.lastname: Leite
authors.forename: Valdemar
authors.initials: V
authors.lastname: Ortiz
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000601:surgery*