Survival analysis of 100 cases of partial cystectomy for pelvic lymph node-negative muscle invasive bladder cancer

Abstract

Objective To report the effect of partial cystectomy (PC) plus chemotherapy in the treatment of pelvic lymph node-negative muscle invasive bladder cancer (MIBC) among selective patients and identify the predictive factors for survival and recurrence after PC.Methods One hundred cases of PC for MIBC (pT2-3 No Mo) between 2002 and 2010 were retrospectively reviewed.Univariate and multivariate analyses were performed to determine the predictive factors for prognosis.Results The mean follow-up period was 58 months (range 9 to 120 months).Of the 100 patients,54 did not have tumor recurrence,12 (12％) had superficial recurrence in the bladder that was treated successfully and 4 of them had late recurrence of muscle invasive disease,34 had advanced recurrence of disease.Thirty-two patients died of bladder cancer and 50 patients survived with intact bladder.The 5-year overall survival (OS),cancer-specific survival (CSS) and recurrence free survival (RFS) were 58％,64％ and 50％,respectively.The multivariable analysis showed that besides history of urothelial carcinoma (H.UC),lymphovascular invasion (LVI) and ureteral reimplantation (UR) were independent risk factors for OS,CSS and RFS.Conclusions H.UC and UR should be deemed as contraindications for PC and LVI predicts poor outcomes after PC.PC plus chemotherapy is effective management for MIBC with negative pelvic lymph node among selective patients. Key words: Urinary bladder neoplasms; Muscle invasive bladder cancer; Partial cystectomy; Lymphovascular invasion ; Ureteroreimplantation