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The role of radical cystectomy in the management of high grade superficial bladder cancer (PA, P1, PIS and P2)

Abstract
Between January 1979 and 1987, 411 consecutive patients were considered candidates for bilateral pelvic iliac lymph node dissection and radical cystectomy for the management of bladder cancer. From this group 160 were identified as having pathological stage P2 or less disease, including 11 who also had positive nodes. The 5-year actuarial survival rate for the respective stages at 95% confidence limits was 100% for stage P0/A, 80% for stage P1, 78% for stage P1 with stage PIS, 85% for pure stage PIS, 76% for stage P2 and 87% for stage P2 with stage PIS. Additionally, we identified a group of patients with stage P2 transitional cell carcinoma who were at significant risk for development of metastatic disease. Of 46 patients with stage P2 transitional cell carcinoma 18 had vascular space invasion resulting in 6 of 18 cancer-related deaths (33%). Our study demonstrates that radical cystectomy has been highly effective in curing patients with high grade superficial disease, including those with superficially invasive disease associated with nodal metastases.
AuthorsS B Malkowicz, P Nichols, G Lieskovsky, S D Boyd, J Huffman, D G Skinner
JournalThe Journal of urology (J Urol) Vol. 144 Issue 3 Pg. 641-5 (Sep 1990) ISSN: 0022-5347 [Print] United States
PMID2388320 (Publication Type: Journal Article)
Topics
  • Carcinoma, Transitional Cell (mortality, pathology, surgery)
  • Cystectomy
  • Female
  • Follow-Up Studies
  • Humans
  • Lymph Node Excision
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Survival Rate
  • Time Factors
  • Urinary Bladder Neoplasms (mortality, pathology, surgery)

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