Clinical outcome of a large-scale multi-institutional retrospective study for locally advanced bladder cancer: a survey including 1131 patients treated during 1990-2000 in Japan.

Abstract

We conducted a multi-institutional analysis to establish the contemporary clinical outcome of invasive bladder cancer treated with radical cystectomy in Japan. A total of 1131 consecutive patients who underwent radical cystectomy for invasive bladder cancer between January 1990 and December 2000 at 32 hospitals were retrospectively analyzed. Histopathological analysis demonstrated that 1042 patients (92.1%) harbored transitional cell carcinomas (TCCs), whereas 89 patients (7.9%) presented non-TCCs, including squamous cell carcinoma and adenocarcinoma. Pelvic lymphadenectomy was performed in 1013 patients in total, and pathologically confirmed lymph node metastases were found in 162 (16.0%). The overall survival at 5 years was 68.0% and most deaths (79.0%) occurred within 3 years. Multivariate analysis demonstrated that gender, clinical stage, pathological stage, lymph node involvement and lymph node dissection were the independent predictive factors for survival, whereas histological type, sex and grade had no significant impact on survival. These clinical results demonstrate that radical cystectomy with lymph node dissection results in good survival for invasive bladder cancer, providing standard data with which other forms of therapy can be compared.