Patient's outcome of bladder cancer managed by radical cystectomy with lymphadenectomy at a university hospital.
OBJECTIVE
To study the impact of tumour staging and nodal metastases in predicting 5- year's survival after radical cystectomy and bilateral pelvic lymphadenectomy for primary bladder cancer.


METHODS
During the period 1995 to 2005, 58 patients underwent radical cystectomy and bilateral pelvic lymphadenectomy and urinary diversion at a University hospital. Patients were identified using medical indexing coding system (ICD 9CM) using standard key words. The patient records were analyzed and follow up data updated. Disease specific survival, death or recurrence was taken as end point.


RESULTS
Out of 58 patients, 50 (86%) were males and 8 (14%) females with a mean age of 61 +/- 13.1 years (range from 27 to 87 years). Of 58 patients, 11 (23%) were excluded from the study because of in adequate follow up. The mean follow up was 5.7 years (range, 7 months to 11 years). The overall 5 years survival was 55% with disease specific survival being 66%. Patients with pathological stage TO at cystectomy have 87% 5 years disease specific survival compared to 60%, in patients with pT4 (p = 0.705). The 5-year survival for node positive patients was 16%, compared to 60% for node negative patients (p < 0.01).


CONCLUSIONS
Radical cystectomy and bilateral pelvic lymphadenectomy is the standard treatment for muscle invasive and high grade T1 cancers, and as salvage for recurrent cancers. Lymphadenectomy has a potential therapeutic benefit. The pathological stage at cystectomy and nodal status are predictors of 5 years survival.
Department of Surgery, Aga Khan University, Karachi.
M Hammad
MH
Ather
Anila
A
Jamshaid
Zaheer
Z
Alam
Khurrum M
KM
Siddique
M Nasir
MN
Sulaiman
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000379:methods*; D018450:Disease Progression; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013534:Survival; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000601:surgery*