1990 Volume 81 Issue 4 Pages 601-607
The relationship between histopathological characteristics and their long-term prognosis was studied on a total of 110 patients with bladder cancer who underwent total cystectomy from 1978 to 1985 at Keio University Hospital in the period after computer tomography (CT) was initiated for the evaluation of tumor stagings.
The actuarial five-year survival rate in the 110 patients estimated by Kaplan-Meier method was 54.3%. Disclosed as histological poor prognostic factors (p<0.05) were the presence of non-transitional cell elements (actuarial five-year survival rate: 26.3%), INFγ for growth patterns (26.3%), grade-3 for histological grades (39.1%), lymph-duct involvement ly(+) (28.2%), venous involvement v(+) (25.2%), muscle-invaded tumor and extravesical lymphnode involvement.
As for the comparative relation among these histological factors, grade-3 tumors tended to have a high incidence of lymph-duct involvement (73.2%), venous involvement (26.8%) and positive lymphnodes (35.7%) when compared to grade-2 tumors. The analysis of the degree of influence of those histological prognostic factors using the non-proportional hazard model revealed that the major priorities were positive lymphnodes (p=0.0006), histological types (p=0.0036) and lymph-duct involvement (p=0.0839).
These results suggest that intensive adjuvant treatment should be indicated for improving the prognosis of patients with bladder cancer who have undergone total cystectomy when non-transitional cell elements and/or vascular involvement are evidenced.
