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[Selective bladder sparing with transrectal resection of muscle-infiltrating tumors]
A Páez Borda1, M Luján Galán, I Romero Cajigal
1Servicio de Urología, Hospital Universitario de Getafe, Madrid.
Objective:
To disclose te ability of TUR as monotherapy in muscle invasive bladder cancer.
Material And Methods:
27 patients with muscle-invasive bladder cancer recruited throughout 1991-1999 were allocated into a protocol based on TUR. 30-45 days after the first TUR a second procedure was performed. The number of recurrences and progressions was registered. Progression-free survival and survival were analyzed using Kaplan-Meier estimates.
Results:
Two patients were excluded due to persistence of muscle-invasive disease after the second resection. 8 subjects (32%) were lost in follow-up. 17 were eventually evaluable. 12 patients (70.5%) had recurrences. Eventually, 4 more cystectomies were undertaken for invasive recurrences (4/17, 23.5%). During the study period, 3 deaths were recorder (3/17, 17.6%). The actuarial probability of progression at 93 months was estimated on 60%.
Conclusions:
75% of patients retained their bladders. The proportion of patients lost in follow-up was very high. Patients must commit to a close surveillance.