1987 Volume 78 Issue 12 Pages 2098-2107
From January 1961 to June 1986, 738 patients with bladder tumors were treated at the Center for Adult Diseases, Osaka. A statistical study was made on these patients. The results are as follows:
1) As to age incidence, the peak incidence was found in the seventh decade. The age distribution was from 19 to 88 years old with the average of 61.8. Male to female ratio was 4.6:1.
2) As to main clinical symptoms, gross hematuria was found most frequently in 83%, pain on urination in 16%, pollakiuria in 14% and dysuria in 7%.
3) As to the cell type, transitional cell carcinoma was found in 705 patients (96%), squamous cell carcinoma in 11 patients (1%), adenocarcinoma in 11 patients (1%), undifferentiated carcinoma in 4 patients and inverted papilloma in 7 patients.
4) Solitary tumors were observed in 48% of 705 patients with transitional cell carcinoma, and multiple tumors in 47%. Small tumors (less than 1cm) were observed in 12%, medium sized tumors (1-3cm) in 58%, and large tumors (more than 3cm) in 23%.
5) As to the histological grade, of the patients with transitional cell carcinoma, 333 patients (47%) were classified as G1, 250 patients (35%) as G2 and 122 patients (17%) as G3.
6) As to the histological stage, of the patients with transitional cell carcinoma, 19 patients (3%) were in pTis, 240 patients (34%) in pTa, 251 patients (36%) in pT1, 80 patients (11%) in pT2, 29 patients (4%) in pT3a, 32 patients (5%) in pT3b, 21 patients (3%) in pT4 and 33 patients (5%) in pTX.
7) As to the first treatment, 436 patients underwent transurethral resection, 9 patients supravesical tumor resection, 33 patients partial cystectomy and 134 patients total cystectomy.
8) The overall actuarial survival rates after the first treatments were 68.5%, 54.2% and 40.6% at 5, 10 and 15 years, respectively. The relative survival rates were 80.2% and 77.1% at 5 and 10 years, respectively. As for tumor characteristics, transitional cell carcinoma rather than squamous cell carcinoma or adenocarcinoma, papillary rather than nonpapillary, low grade rather than high grade, low stage rather than high stage, solitary rather than multiple and small rather than large tumors yielded better survival.
9) The intravesical recurrence rates after transurethral resection were 29.6%, 44.2% and 55.4% at 1, 2 and 5 years, respectively. Intravesical recurrence was significantly more frequent in patients with high grade, high stage, multiple or large tumors at first treatment.
