Abstract
Nine hundred and seventy-six patients with bladder carcinoma underwent surgery as an initial treatment from 1960 to 1982. They were divided into three groups according to the following three treatment modalities: transurethral resection (TUR, 492cases), partial cystectomy (PC, 331 cases) and total cystectomy (TC, 153 cases). The relations of treatment results to clinicopathological profiles of each group were analyzed. Five year relative survival rates of TUR, PC and TC groups were 93±2%, 79±3% and 31±4% (M±SE), respectively. The average age of patients and the number of patients having tumors of high grade, advanced stage and large size were found increased in the order of TUR, PC and TC groups. The incidence of patients having a single tumor was highest in PC group among the three groups. The number of patients receiving PC markedly decreased recently.
The patients' ages had nothing to do with the relative five year survival rates of TUR and PC groups. In TC group, however, patients over 60 years old had poor prognosis when compared with younger ones. The five year survival rate of infiltrative tumor (T2, 3 and 4) was worse than superficial ones in each group. PC achieved the best result as a treatment for T2 tumors among the three treatment modalities, which led to the best five year survival rate of patients having infiltrative tumors in PC group among the three groups. High tumor grade and increase of tumor size resulted in poor prognosis in TUR and PC groups. In PC group, multiple tumors also resulted in poor prognosis. The five year survival rates of PC and TC groups have been improved recently.
From the results above stated, it appears likely that the poor five year survival rate of TC group resulted from the advanced age of patients and operative complications as well as the high incidence of the patients with high grade and infiltrative tumors, and that PC is a valuable treatment for a single tumor, especially in the stage T2.
