Outcomes for a large series of radical cystectomies for bladder cancer.
OBJECTIVE
We present the characteristics and outcomes of a large Chinese series of patients treated with radical cystectomy and pelvic lymphadenectomy for invasive cancer of the bladder. Our aim is to determine the significant independent prognostic factors that determine this outcome.


METHODS
The records of 356 patients with invasive bladder cancer, operated at three Chinese medical institutes between 1995 and 2004, were reviewed. Of the 356 patients, 324 (91.0%) were TCC, 24 (6.7%) were adenocarcinoma, eight (2.3%) were squamous carcinoma. The incidence of pelvic lymph node involvement was 22.8%. The mean (SD, range) follow-up of the 356 patients was 54.89 (31.66, 3-137) months. Multivariate analysis was used to assess the clinical and pathological variables affecting disease-free survival (DFS).


RESULTS
The 1-, 2- and 5-year DFS rates were 87%, 75% and 48%, respectively. In multivariate analysis, tumor configuration (RR=1.62, p=0.012), multiplicity (RR=1.41, p=0.036), histological subtype (RR=2.17, p<0.001), tumor stage (RR=2.50, p<0.001), tumor grade (RR=2.40, p<0.001), node status (RR=2.51, p<0.001), neoadjuvant chemotherapy (RR=0.46, p=0.016) had independent significance for survival on multivariate analysis.


CONCLUSIONS
The results of this series show that radical cystectomy and pelvic lymphadenectomy provide durable local control and DFS in patients with invasive bladder cancer. Multivariates affect the prognosis after radical cystectomy for invasive bladder cancer. The treatment of invasive bladder cancer in China is still in need of improvement and normalization.
Niu
H T
HT
Department of Urology, The Affiliated Hospital of Medical College Qingdao University, ShiNan district, 16 Jiangsu Road, Qingdao 266003, China. Electronic address: Niuhaitao1976@yahoo.com.cn.
Xu
T
T
Department of Geratology, The 401th Hospital of PLA, 22 Minjiang Road, Qingdao 266000, China.
Zhang
Y B
YB
Department of Pathology, North China Coal Medical College, 57 Jianshenan Road, Tangshan 063000, China.
Pang
D Q
DQ
Department of Urology, TianJin Institute of Urology, The second Hospital of Tianjin Medical University, 23 Pingjiang Road, Tianjin 300211, China.
Zhang
Z L
ZL
Department of Urology, The Affiliated Municipal Hospital of Medical College Qingdao University, 1 Jiaozhou Road, Qingdao 266011, China.
Wu
S
S
Department of Urology, The Affiliated Municipal Hospital of Medical College Qingdao University, 1 Jiaozhou Road, Qingdao 266011, China.
Cheng
B
B
Department of Urology, TianJin Institute of Urology, The second Hospital of Tianjin Medical University, 23 Pingjiang Road, Tianjin 300211, China.
Wang
Y
Y
Department of Urology, TianJin Institute of Urology, The second Hospital of Tianjin Medical University, 23 Pingjiang Road, Tianjin 300211, China.
Chang
J W
JW
Department of Urology, TianJin Institute of Urology, The second Hospital of Tianjin Medical University, 23 Pingjiang Road, Tianjin 300211, China.
Sun
G
G
Department of Urology, TianJin Institute of Urology, The second Hospital of Tianjin Medical University, 23 Pingjiang Road, Tianjin 300211, China.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D015653:Cystectomy / Q000379:methods; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D010388:Pelvis; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy / Q000601:surgery*