THE VALUE OF PELVIC ARTERIOGRAPHY IN THE DIAGNOSIS AND PROGNOSIS ON BLADDER CANCER

Abstract

To determinate stages of bladder cancer, pelvic arteriography was performed in 201 patients. Arteriographical staging was classified into 3 groupes according to Shiraishi's criteria; type I with submucosal infiltration, type II with muscular infiltration and type III with extravesical extention.
These arteriographic diagnosis was compared with other clinical examinations, pathological inspections and the prognosis. The following results were obtained.
1) The correspondence of arteriographic types to histological staging was 75.5% in all cases, 65.1% in type I, 80% in type II and 85% in type III.
2) The arteriographic accuracy was more excellent when tumor was in the lateral wall of the bladder than in the base of the bladder.
3) We concluded that pelvic arteriography was unnecessary for a pedunculated, papillary bladder tumor of underthumb head size.
4) 98.5% of type I group and 92.7% of type II group was under B₂ in staging, and therefore pelvic arteriography is a clinically significant examination according to our therapeutic principle that a tumor under B₂ in staging is indicated for radical operation.
5) Prognosis of type III group was extremely poor and it corresponded well with the prognosis of stage C-D group. This suggests that our therapeutic principle, mentioned above, is clinically appropriate and that the findings of pelvic arteriography are important in the presumption of prognosis of bladder cancer patients.