RADICAL CYSTECTOMY FOR TRANSITIONAL CELL CARCINOMA OF THE BLADDER
1986 Volume 77 Issue 1 Pages 79-86
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1986 Volume 77 Issue 1 Pages 79-86
One hundred and thirty-six patients with transitional cell carcinoma of the urinary bladder were treated with radical cystectomy with pelvic lymph nodes dissection at the Department of Urology, National Cancer Center Hospital, Tokyo from 1962 to December, 1984.
Twenty-nine patients had positive nodes (21%): 2 of 43 (4.7%) in the stage of pT1, 3 of 16 (19%) in pT2, 9 of 28 (32%) in pT3 and 15 of 23 (65%) in pT4. None of the 26 patients in pTis and pTa had lymph nodes metastasis. Obturator lymph nodes were most frequently involved (72%) followed by external iliac lymph nodes (52%), hypogastric lymph nodes (48%) and common iliac lymph nodes (38%).
The 5-year survival rate according to pathological stage was 100% for patients in pTis, 72.2% in pTa, 79.6% in pT1, 39.5% in pT2, 35.8% in pT3, 25.9% in pT4. Patients with positive nodes irrespective of their stage had poor prognosis (5-year survival rate: 25.7%).
Among 67 patients with low stage disease (pTis-pT1) having negative lymph nodes, only 4 died of cancer (3 of them died of urethral reccurrence, 1 died of distant metastasis). Eighty-five per cent of 27 patients with invasive disease (pT2-pT4) Who died of cancer was due to distant metastases, indicating urgent necessity to develop effective adjuvant chemotherapy.
