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, D. J. Grignon

Research output: Contribution to journalArticle

2 Scopus citations

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.

Translated title of the contributionSurvival in stage T2-T3A bladder cancer treated with radical cystectomy
Original languageSpanish
Pages (from-to)17-23; discussion 24-25
JournalArchivos españoles de urología
Volume50
Issue number1
StatePublished - Jan 1 1997

ASJC Scopus subject areas

  • Urology

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    Angulo Cuesta, J., Sánchez Chapado, M., Guil Cid, M., Flores Corral, N., Pontes, E. J., & Grignon, D. J. (1997). Supervivencia del cáncer de vejiga estadio T2-T3A tratado mediante cistectomía radical. Archivos españoles de urología, 50(1), 17-23; discussion 24-25.