Radical cystectomy for primary bladder malignancy: a 10 year review

Area of Science:

• Urology
• Oncology
• Surgical Oncology

Background:

• Radical cystectomy is the standard treatment for muscle-invasive bladder cancer.
• Limited recent reviews exist from centers outside major international hubs.
• This study compares institutional outcomes with published literature.

Purpose of the Study:

• To evaluate the outcomes of radical cystectomy for bladder cancer at a single institution.
• To compare these results with existing published data.
• To assess survival rates, recurrence, and postoperative morbidity.

Main Methods:

• Retrospective review of 50 consecutive patients undergoing radical cystectomy for bladder carcinoma (1995-2005).
• Analysis of patient demographics, tumor characteristics, treatment history, recurrence, survival, and postoperative complications.

Main Results:

• The study included 50 patients (76% male, mean age 70). 46% had prior superficial bladder cancer, and 24% had intravesical therapy.
• 94% had transitional cell carcinoma, 76% poorly differentiated, with 48% at pT3 stage or higher and 35% lymph node involvement.
• Recurrence occurred in 46% within 12 months, associated with higher pT stage. Five-year disease-free and overall survival were 42% and 34%, respectively. Postoperative mortality was 2%.

Conclusions:

• Survival after radical cystectomy for bladder cancer remains modest.
• Higher stage disease and lymph node involvement significantly impact recurrence and survival.
• Institutional outcomes for morbidity, mortality, and length of stay are acceptable compared to international benchmarks.