Supervivencia del cáncer de vejiga estadio T2-T3A tratado mediante cistectomía radical.

Translated title of the contribution: Survival in stage T2-T3A bladder cancer treated with radical cystectomy

J. Angulo Cuesta, M. Sánchez Chapado, M. Guil Cid, N. Flores Corral, E. J. Pontes, David Grignon

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVE: The optimal treatment for patients with localized muscle-infiltrating urothelial carcinoma (Jewett stage B or T2-T3a of the TNM classification, UICC 1992) continues to be a controversy. The present study analyzed the survival rate in patients with stage T2-T3a bladder cancer who had been treated by radical cystectomy. METHODS: The records of 50 patients with T2-T3a NO tumor, submitted to pelvic lymphadenectomy and radical cystoprostatectomy, were reviewed to determine the prognosis in this group of patients. Seventeen patients (34%) received three courses of systemic chemotherapy (CMV) prior to cystectomy. RESULTS: The overall 5-year survival rate was 73%; 76% for those with T2 (n = 30) and 67% for those with T3a (n = 20) (log-rank, p = 0.27). No statistically significant differences were observed for age (less than or over 65 years), tumor growth pattern (papillary or flat), tumor size (less or greater than 5 cms) or treatment (with or without induction CMV). However, patients with G1-2 tumor had a better survival rate (94% at 5 years) than those with G3 tumor (51%), a difference with statistical significance (log-rank, p = 0.047). The Cox regression analysis showed no independent variable of prognostic significance. CONCLUSION: Muscle-infiltrating urothelial carcinoma is highly curable by radical surgery. Some authors believe it is unnecessary to distinguish T2-T3a lesions; therefore a critical review of the TNM classification appears to be warranted. We are unable to distinguish patients with a better prognosis that might benefit from less aggressive therapeutic options. Similarly, the therapeutic benefits of induction chemotherapy prior to cystectomy in patients with stage T2-T3a tumor could not be demonstrated.

Original languageSpanish
JournalArchivos Espanoles de Urologia
Volume50
Issue number1
StatePublished - Jan 1997
Externally publishedYes

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Cystectomy
Urinary Bladder Neoplasms
Survival
Neoplasms
Survival Rate
Neoplasm Staging
Carcinoma
Muscles
Induction Chemotherapy
Therapeutics
Lymph Node Excision
Regression Analysis
Drug Therapy
Growth

ASJC Scopus subject areas

  • Urology

Cite this

Angulo Cuesta, J., Sánchez Chapado, M., Guil Cid, M., Flores Corral, N., Pontes, E. J., & Grignon, D. (1997). Supervivencia del cáncer de vejiga estadio T2-T3A tratado mediante cistectomía radical. Archivos Espanoles de Urologia, 50(1).

Supervivencia del cáncer de vejiga estadio T2-T3A tratado mediante cistectomía radical. / Angulo Cuesta, J.; Sánchez Chapado, M.; Guil Cid, M.; Flores Corral, N.; Pontes, E. J.; Grignon, David.

In: Archivos Espanoles de Urologia, Vol. 50, No. 1, 01.1997.

Research output: Contribution to journalArticle

Angulo Cuesta, J, Sánchez Chapado, M, Guil Cid, M, Flores Corral, N, Pontes, EJ & Grignon, D 1997, 'Supervivencia del cáncer de vejiga estadio T2-T3A tratado mediante cistectomía radical.', Archivos Espanoles de Urologia, vol. 50, no. 1.
Angulo Cuesta J, Sánchez Chapado M, Guil Cid M, Flores Corral N, Pontes EJ, Grignon D. Supervivencia del cáncer de vejiga estadio T2-T3A tratado mediante cistectomía radical. Archivos Espanoles de Urologia. 1997 Jan;50(1).
Angulo Cuesta, J. ; Sánchez Chapado, M. ; Guil Cid, M. ; Flores Corral, N. ; Pontes, E. J. ; Grignon, David. / Supervivencia del cáncer de vejiga estadio T2-T3A tratado mediante cistectomía radical. In: Archivos Espanoles de Urologia. 1997 ; Vol. 50, No. 1.
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abstract = "OBJECTIVE: The optimal treatment for patients with localized muscle-infiltrating urothelial carcinoma (Jewett stage B or T2-T3a of the TNM classification, UICC 1992) continues to be a controversy. The present study analyzed the survival rate in patients with stage T2-T3a bladder cancer who had been treated by radical cystectomy. METHODS: The records of 50 patients with T2-T3a NO tumor, submitted to pelvic lymphadenectomy and radical cystoprostatectomy, were reviewed to determine the prognosis in this group of patients. Seventeen patients (34{\%}) received three courses of systemic chemotherapy (CMV) prior to cystectomy. RESULTS: The overall 5-year survival rate was 73{\%}; 76{\%} for those with T2 (n = 30) and 67{\%} for those with T3a (n = 20) (log-rank, p = 0.27). No statistically significant differences were observed for age (less than or over 65 years), tumor growth pattern (papillary or flat), tumor size (less or greater than 5 cms) or treatment (with or without induction CMV). However, patients with G1-2 tumor had a better survival rate (94{\%} at 5 years) than those with G3 tumor (51{\%}), a difference with statistical significance (log-rank, p = 0.047). The Cox regression analysis showed no independent variable of prognostic significance. CONCLUSION: Muscle-infiltrating urothelial carcinoma is highly curable by radical surgery. Some authors believe it is unnecessary to distinguish T2-T3a lesions; therefore a critical review of the TNM classification appears to be warranted. We are unable to distinguish patients with a better prognosis that might benefit from less aggressive therapeutic options. Similarly, the therapeutic benefits of induction chemotherapy prior to cystectomy in patients with stage T2-T3a tumor could not be demonstrated.",
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