PTU - Polskie Towarzystwo Urologiczne
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Survival of patients subjected to radical cystectomy due to muscle invasive bladder cancer
Article published in Urologia Polska 2006/59/3.


Artur Lemiński, Marcin Słojewski, Andrzej Sikorski
Katedra i Klinika Urologii Pomorskiej Akademii Medycznej


urinary bladder, bladder cancer, cystectomy, survival


Introduction. Radical cystectomy remains the treatment of choice in invasive bladder cancer. The challenge is to excise the tumor completely and provide the patient acceptable quality of life. Advanced age of patients, coexisiting diseases and tumor burden often make cystectomy only palliative treatment.
The aim of the study. Survival assessment in patients subjected to cystectomy due to invasive bladder cancer.
Material and methods. Between 1989 and 2003 there were 201 cystectomies performed in our urology department. Data for survival analysis were obtained from questionnaire study and local authorities' database. Mean age of patients (86.4% men, 13.6% women) was 60.8 (31-85 years). Kaplan-Meier's method, Cox-Mantel test and Cox proportional hazard regression test were used to perform statistical analysis. Influence of tumor stage, grade, sex and age of patients on overall survival was retrospectively evaluated. Statistical significance ratio was p<0.05.
Results. Mortality during first 30 days after surgery was 5.4%. Median postoperative survival was 14.7 months. Cumulative 5-year survival: 24.6%. At the end of observation (31.01.2004) 26.37% of patients (53) were alive. Lymph node involvement reflected strongest negative impact on survival (p<0.0001). Tumor stage (p<0.001), distant metastases (p<0.005), tumor grade (p<0.05) advanced age of patients (p<0.001) were negative prognostic factors. Gender had no influence on survival.
Conclusions. There is a high mortality among patients after radical cystectomy. Lymph node involvement remains the strongest negative prognostic factor. Depth of bladder wall infiltration, distant metastases and advanced age of patients show negative impact on survival. Tumor grade reflects weaker influence on survival. Gender has no prognostic value.


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Artur Lemiński
Klinika Urologii PAM
ul. Powstańców Wielkopolskich 72
70-111 Szczecin
tel. (091) 466 11 00