[Clinical evaluation of total cystectomy in patients with bladder cancer]

Thirty-one patients with bladder tumors underwent total cystectomy between April, 1969 and March, 1984. The overall five-year survival rate was 62.2%, and the ten-year survival rate was 55.0%. However, 11 of the 12 cancer deaths occurred within 5 years. The survival rate was significantly higher in G1 than in G2 or G3, but there was no significant difference between G2 and G3. The survival rate was clearly different between the superficial and deep invasive type. The group of stage pT1a or less had a significantly higher survival rate than the group of pT1b. No significant difference was detected among the groups of stage pT1b or higher. The presence of intramural lymphatic invasion (ly) may be an important prognostic factor. Pelvic lymph node metastasis was detected in 28.6% of ly 1, and in 71.4% of ly 2. The bladder cancer could be rationally classified into a superficial type and an invasive type according to the destruction of the lamina proprie. Proper adjuvant therapy should be performed for the invasive type which shows ly-positive cancer.