[Predictive factors and long term carcinogenic results of patients who no longer have residual tumors (stage pT0) on specimens of total cystectomy carried out for cancer of the bladder].
OBJECTIVE
The aim of our study was to evaluate predictive factors and long-term carcinogenic results for patients who had had a total cystectomy for cancer of the bladder and whose final histological results did not show evidence of a residual tumor.


METHODS
From 1988 to 2002, 192 patients had a total cystectomy for a bladder tumor. No residual tumor (pT0) was evident in the specimens of cystectomy of 22 patients (11.5%). None of the patients had distant metastasis or ganglions at the time of the initial examination.


RESULTS
Predictive factors for having no residual tumors based on the specimen of cystectomy (pT0) were an antecedent of neo-adjuvant chemotherapy (p=0.0079), an interval between the resection of the bladder and the cystectomy of more than 12 weeks (p=0.0014) and a resection of the initial bladder considered complete (p=0.0036). The average treatment of these 22 patients was 70+/-46 months. During treatment, two patients (9%) had a recurrence in the pelvis and 10 patients died including one from the development of his cancer of the bladder. Global, specific and non-recurrence survival at five years were 75%, 100% and 94%, respectively. We revealed better specific survival (p=0.0007) and without relapse (p<0.0001) in patients who no longer had a tumor on the specimen of cystectomy (pT0) compared with patients who had a residual tumor (pT+) but with no difference in global survival (p=0.0574).


CONCLUSIONS
The absence of residual tumors (pT0) on a specimen of total cystectomy for cancer of the bladder was a good factor for prognosis regarding long-term survival even if tumor development was observed. Complete resection and neo-adjuvant chemotherapy probably played a beneficial role in the future of these patients.
Service d'urologie, clinique urologique, CHU Hôtel-Dieu, 1, place Alexis-Ricordeau, 44000 Nantes, France.
M
M
Hitier
L
L
Marconnet
F
F
Luyckx
J
J
Branchereau
G
G
Braud
G
G
Karam
O
O
Bouchot
J
J
Rigaud
D000368:Aged; D015653:Cystectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D015996:Survival Rate; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*