Predictors of outcome after radical cystectomy for bladder cancer in saudi patients; single institution experience

To evaluate different prognostic factors that may affect disease-specific survival in patients with bladder cancer following radical cystectomy.

Between July 1975 and December 2000, 229 patients underwent radical cystectomy and urinary diversion for bladder cancer in King Faisal Specialist Hospital and Research Center (KFSH & RC), Riyadh, Saudi Arabia. 175 patients had available records for review. Retrospective chart review was done. Demographic, clinical and pathological variables which may affect disease specific survival in bladder cancer patients were pooled. Univariate and multivariate analyses were done with disease specific survival as an end point.

Our patients were 140 males (80%) and 35 females (20%). Their mean age was 54 years (range: 21-90 years). The median follow-up period was 1.5 years (range: one month-19 years). Five-year disease specific survival was 44%. On univariate analysis, patients' age, lymph node status, pathological staging and presence of hydronephrosis were significant predictors of disease specific survival. However, only lymph node status (p<0.0001), pathological staging (p=0.0411) & presence of hydronephrosis (p=0.0264) were significant predictors of disease specific survival in multivariate analysis.

Pathological stage, lymph node status and upper obstructive uropathy are significant prognostic factors in bladder cancer patients after radical cystectomy. These factors may help to define bladder cancer patient groups who require further therapy or enrollment in controlled trials to investigate additional therapy.