Impact of the level of muscle invasion in organ-confined bladder cancer.
OBJECTIVE
We evaluated whether there is a survival difference between patients having pT2a and pT2b invasive bladder carcinomas without nodal involvement and distant metastases.


METHODS
Three hundred and thirty-six patients with invasive carcinomas of the bladder underwent radical cystectomy. Seventy-five patients with organ-confined disease were evaluated. The pathological stage was used as predictor of survival. Kaplan-Meier method and log-rank test were used to evaluate survival rates. Cox proportional-hazard models were used to identify whether pathological stage, grade, diversion type, age, and gender affect the outcome.


RESULTS
Thirty-five patients were in the pT2aN0 group with a mean age of 57.8 +/- 1.4 (range 37-76) years, and 40 patients were in the pT2bN0 group with a mean age of 59.5 +/- 1.1 (range 37-76) years. There were 2 female patients. The mean follow-up period was 27.41 +/- 20.5 (range 3-80) months. The disease-specific 5-year survival rate of the pT2N0 cases was 80.3%. The disease-specific 5-year survival rates for the pT2aN0 and pT2bN0 patients were 84.3 and 66.0%, respectively. The disease-specific mean survival times of pT2aN0 and pT2bN0 cases were 76.2 +/- 4.7 and 56.3 +/- 7.7 months, respectively. There was no statistically significant survival difference between pT2aN0 and pT2bN0 patients by log-rank test (p = 0.1767). According to the Cox multivariate regression analysis, stage, grade, diversion type, age, and gender were not predictive of the survival in patients with organ-confined bladder cancer (p > 0.05).


CONCLUSIONS
The level of muscle invasion in organ-confined bladder cancer does not have an influence on the patient survival. Also stage, grade, diversion type, age, and gender are not predictive of survival in patients with organ-confined muscle-invasive bladder cancer.
Girgin
Cengiz
C
1st Urology Department, Ataturk Training and Research Hospital, Izmir, Turkey. girgincengiz@hotmail.com
Sezer
Akif
A
Delibaş
Mustafa
M
Sahin
Oğuz
O
Oder
Mehmet
M
Dinçel
Cetin
C
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology*