[Clinical evaluation of total cystectomy for bladder carcinoma: a ten-year experience]

Fifty-three patients with primary bladder carcinoma underwent total cystectomy during the past 10 years. Ages ranged from 32 to 87 years old, with an average of 68.2 years. Radical total cystectomy, including systemic lymphadenectomy was performed in 22 cases, simple total cystectomy in 8 cases and salvage total cystectomy in 23 cases. An ileal conduit was made for urinary diversion in 23 cases and the other 26 cases underwent cutaneous ureterostomy. Postoperative mortality was 9.4% (5 of 53 cases) and postoperative complications were noted in 17 of the 53 cases (32.1%). The 5-year cumulative survival rate by the life table method for all the cases was 42.6%. The 5-year cumulative survival rate of radical total cystectomy cases was 67.8%, that of simple total cystectomy cases was 50.0% and that of salvage total cystectomy cases was 7.5%. A significant difference was seen between the first 2 groups and the last group. The 5-year cumulative survival rate of the patients with low stage cancer (pTis, pTa, pT1 and pT2) was 56.1% and that of the patients with high stage cancer (pT3, pT4) was 22.7%. A significant difference was observed between the two groups. The 5-year cumulative survival rate of the patients with grades G1, G2 and G3 cancer was 66.7, 45.4 and 26.7% respectively. A significant difference was seen among the three grades.