Abstract
Of 113 patients with bladder cancer who underwent total cystectomy from January 1980 to December 1990, 30 (27%) had superficial tumours (pTa, pTis, and pT1). Nineteen of these 30 patients (63%) were primarily treated by total cystectomy and the remaining 11 (37%) had a past history of treatment for bladder cancer. Major reasons for choice of total cystectomy were multifocal tumours, frequent recurrence, and diffuse carcinoma in situ. Histologically stage pT1, grade 3 tumours were frequently accompanied by carcinoma in situ and often by lymphatic invasion. None of the 24 patients undergoing pelvic lymphadenectomy had lymph node metastasis. Of 25 male patients 15 (60%) underwent simultaneous prophylactic urethrectomy. Two of the remaining 10 males (20%) not undergoing this additional operation died of subsequent urethral recurrence. The 5-year actuarial survival rate was 80% for the 30 patients when all causes of death were considered. It was concluded that patients with superficial bladder cancer who undergo total cystectomy without prophylactic urethrectomy require close follow-up with urethral washings for cytology to detect early urethral recurrence, an important determinant for survival.
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References
Abel, P. D.: Prognostic indices in transitional cell carcinoma of the bladder.Br. J. Urol., 62, 103 (1988).
Althausen, A. F., Prout, G. R. Jr., Daly, J. J.: Non-invasive papillary carcinoma of the bladder associated with carcinoma in situ.J. Urol., 116, 575 (1976).
Anderström, C., Johansson, S., Nilsson, S.: The significance of lamina propria invasion in the prognosis of patients with bladder tumors.J. Urol., 124, 23 (1980).
Heney, N. M., Ahmed, S., Flanagan, M. J., Frable, W., Corder, M. P., Hafermann, M. D., Hawkins, I. R.: Superficial bladder cancer: Progression and recurrence.J. Urol., 130, 1083 (1983).
Jakse, G., Loidl, W., Seeber, G., Hofstädter, F.: Stage T1, grade 3 transitional cell carcinoma of the bladder: An unfavorable tumor?J. Urol., 137, 39 (1987).
Takashi, M., Sakata, T., Murase, T., Miyake, K., Hamajima, N.: Grade 3 bladder cancer with lamina propria invasion (pT1): Characteristics of tumor and clinical course.Nagoya J. Med. Sci., 53 (1991, in press).
Coplen, D. E., Marcus, M. D., Myers, J. A., Ratliff, T. L., Catalona, W. J.: Long-term followup of patients treated with 1 or 2, 6-week courses of intravesical bacillus Calmette-Guérin: Analysis of possible predictors of response free of tumor.J. Urol., 144, 652 (1990).
Takashi, M., Agai, T., Murase, T., Miyake, K., Hamajima, N., Mizuno, S.: Multivariate evaluation of determinants affecting regional lymph node metastasis and survival in bladder cancer patients who underwent radical cystectomy.Urol. Int., 44, 125 (1989).
Malkowicz, S. B., Nichols, P., Lieskovsky, G., Boyd, S. D., Huffman, J., Skinner, D. G.: The role of radical cystectomy in the management of high grade superficial bladder cancer (Pa, P1, PIS and P2).J. Urol., 144, 641 (1990).
Zabbo, A., Montie, J. E.: Management of the urethra in men undergoing radical cystectomy for bladder cancer.J. Urol., 131, 267 (1984).
Ahlering, T. E., Lieskovsky, G., Skinner, D. G.: Indications for urethrectomy in men undergoing single stage radical cystectomy for bladder cancer.J. Urol., 131, 657 (1984).
Koss, L. G.: Tumors of the Urinary Bladder. Atlas of Tumor Pathology. 2nd ser., fasc. 11, Armed Forces Institute of Pathology, Washington D. C. 1975.
Union Internationale Contre le Cancer: TNM classification of malignant tumours. (Union Internationale Contre le Cancer, Geneva 1974.
Kaplan, E. L., Meier, P.: Nonparametric estimation from incomplete observations.J. Am. Stat. Ass., 53, 457 (1958).
Gehan, E. A.: A generalized Wilcoxon test for comparing arbitrarily single-censored samples.Biometrika, 52, 203 (1965).
Kakizoe, T., Matsumoto, K., Nishio, Y., Ohtani, M., Kishi, K.: Significance of carcinoma in situ and dysplasia in association with bladder cancer.J. Urol., 133, 395 (1985).
Cordonnier, J. J., Spjut, H. J.: Urethral occurrence of bladder carcinoma following cystectomy.J. Urol., 87, 398 (1962).
Schellhammer, P. F., Whitmore, W. F. Jr.: Transitional cell carcinoma of the urethra in men having cystectomy for bladder cancer.J. Urol., 115, 56 (1976).
Raz, S., McLorie, G., Johnson, S., Skinner, D. G.: Management of the urethra in patients undergoing radical cystectomy for bladder carcinoma.J. Urol., 120, 298 (1978).
Hardeman, S. W., Soloway, M. S.: Urethral recurrence following radical cystectomy.J. Urol., 144, 666 (1990).
Ghoneim, M. A., Kock, N. G., Lycke, G., El-Din, A. B. S.: An appliance-free, sphincter-controlled bladder substitute: The urethral Kock pouch.J. Urol., 138, 1150 (1987).
Thüroff, J. W., Alken, P., Riedmiller, H., Jacobi, G. H., Hohenfellner, R.: 100 cases of Mainz pouch: Continuing experience and evolution.J. Urol., 140, 283 (1988).
Zincke, H., Garbeff, P. J., Beahrs, J. R.: Upper urinary tract transitional cell cancer after radical cystectomy for bladder cancer.J. Urol., 131, 50 (1984).
Malkowicz, S. B., Skinner, D. G.: Development of upper tract carcinoma after cystectomy for bladder carcinoma.Urology, 36, 20 (1990).
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Takashi, M., Sakata, T., Nakano, Y. et al. Superficial bladder cancer treated by total cystectomy: Tumour characteristics and patient survival. International Urology and Nephrology 24, 265–271 (1992). https://doi.org/10.1007/BF02549534
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DOI: https://doi.org/10.1007/BF02549534