1988 Volume 79 Issue 2 Pages 274-282
Clinical and histopathological investigation were made on 91 patients with bladder cancer who were undergone total cystectomy at the Department of Urology, Kagoshima University Hospital from 1971 to 1986.
5 year survival rate according to pathological stage was 71% for patients in pT1, 55.6% in pT2, 26.5% in pT3a, 19.1% in pT3b. A significant difference between pT2 and pT3a was found in the survival rate (p<0.01).
Based on pathological grade, 5 year survival rate was 100% in Grade 1, 70.4% in Grade 2, 28.4% in Grade 3.
A significant difference in the survival rate was observed between Grade 2 and 3 (p<0.05). 5 year survival rate according to lymphatic carcinomatous permeation also showed significant difference between ly0 and ly1, ly2 (p<0.01). The incidence of recurrence and metastases were 13.2% in lymph nodes, 4.4% in bone and 3.3% in the liver.
Urethral recurrence was recognized in 4 cases (4.4%). Of two cases with liver metastasis and one case with intrapelvic recurrence were detected. As to the incidence of lymph node metastasis according to site, internal iliac lymph nodes were mostly involved (23.1%) followed by obturator lymph nodes (11.3%) and external iliac lymph nodes (6.2%). All of 9 cases with local recurrence showed lymphatic permeation and 7 of 9 cases with distant metastases showed deep lymphatic permeation. It was obvious that not only pathological grade and stage but also lymphatic permeation influenced the prognosis of the cases with bladder cancer.
