Infiltrating transitional cell carcinoma of the bladder--treatment results

This is a review of the treatment results of 100 consecutive patients with infiltrating transitional cell carcinoma of the bladder who underwent cystectomy at Tygerberg Hospital between 1978 and 1989. Radiotherapy was given pre-operatively in 39% and postoperatively in 15%, and systemic chemotherapy was used postoperatively in 12% of the patients. Follow-up was available in 81% of patients, with a mean of 40.8 months (range 1-145 months). The estimated overall 5-year survival rate was approximately 70%, which compares favourably with the 5-year survival rate reported in other series of transitional cell bladder carcinoma treated with radical cystectomy (30-82%). There was a statistically significant decrease in overall 5-year survival in patients with more locally advanced tumours, and in patients with a higher pathological stage relative to clinical tumour stage (upstaging) than in those with a lower pathological stage relative to clinical tumour stage (downstaging). There was no statistically significant difference in overall survival between patient groups aged < 60 and > 70 years, between patients with and without pre-operative radiotherapy, between groups with different tumour grades, between those with and without carcinoma in situ, and between those with and without pelvic lymph node metastases.