Bladder Tumor: 20 years Experiences

Ahn, Han Jong; Lee, Chongwook

Abstract

Five hundred forty three patients with transitional cell carcinoma managed at Seoul National University Hospital during a 20 year period between 1965 and 1984 art analyzed retrospectively. We selected 108 patients with stage A tumor for analysis of recurrence by excluding 95 patient with a prior history of bladder cancer, 14 patients whose initial treatment were a total cystectomy, 12 patients whose disease progressed in stage within 3 years following treatment, 58 patients followed up less than 3 years and 65 patients lost to follow up from 352 patients with stage A tumor. The over-all recurrent rate within the first 3 years following resection of stage A tumor was 70%. The influence of the tumor size, number and grade on recurrence was examined. Disease-free status by 36 months according to the tumor size 1cm or smaller, 1-2cm, 3-4cm, 5cm or larger was 57%, 31%, 17% and 7% respectively. All differences were statistically significant. There was no significant difference of recurrence rate between 1 tumor and 2 tumors, but 3 or more tumors showed significantly higher recurrence rate than 2 or less tumors. There was no significant difference of recurrent rate among grade I, Fade II , grade III tumors combined. Total cystectomies without pelvic lymphadenectomy or preoperative irradiation were performed in 110 patients and 77 patients were adequately followed up. Five-year survival rate of stage A, B, C, D was 87%, 26%, 11%, and 0% respectively. Operative mortality among patients undergoing total cystectomy was 4.5%. Metastases were found in the lymph node, adjacent organs and bone in the order of frequency. Only one patient with stage D tumor on initial presentation survived more than 5 years and the average survival length of stage D was 8 months.