Authors: | Herr, H. W.; Sogani, P. C. |
Article Title: | Does early cystectomy improve the survival of patients with high risk superficial bladder tumors? |
Abstract: | Purpose: We compared survival after early versus delayed cystectomy in patients with high risk superficial bladder tumors. Materials and Methods: Of 307 patients with high risk superficial bladder tumors who were treated initially with transurethral resection and bacillus Calmette-Guerin (BCG) therapy 90 (29%) underwent cystectomy for recurrent tumor during a followup of 15 to 20 years. Disease specific survival distribution of these 90 patients was determined relative to the indications for and time of cystectomy. Results: Of the 90 patients who underwent cystectomy 44 (49%) survived a median of 96 months. Of 35 patients with recurrent superficial bladder tumors 92% and 56% survived who underwent cystectomy less than 2 years after initial BCG therapy and after 2 years of followup, respectively. Of 55 patients with recurrent muscle invasive bladder disease 41% and 18% survived when cystectomy was performed within and after 2 years, respectively. Multivariate analysis showed that survival was improved in patients who underwent earlier rather than delayed cystectomy for nonmuscle invasive tumor relapse. Conclusions: Earlier cystectomy improves the long-term survival of patients with high risk superficial bladder tumors in whom BCG therapy fails. |
Keywords: | adult; cancer survival; aged; middle aged; survival rate; major clinical study; follow up; follow-up studies; neoplasm staging; treatment indication; bcg vaccine; neoplasm recurrence, local; risk factors; bladder tumor; urinary bladder neoplasms; high risk patient; time factors; risk; survival time; tumor recurrence; cystectomy; mycobacterium bovis; multivariate analysis; bladder neoplasms; transurethral resection; adjuvants, immunologic; bladder; superficial cancer; humans; prognosis; human; male; female; priority journal; article |
Journal Title: | Journal of Urology |
Volume: | 166 |
Issue: | 4 |
ISSN: | 0022-5347 |
Publisher: | Elsevier Science, Inc. |
Date Published: | 2001-10-01 |
Start Page: | 1296 |
End Page: | 1299 |
Language: | English |
PUBMED: | 11547061 |
PROVIDER: | scopus |
DOI: | 10.1016/S0022-5347(05)65756-4 |
DOI/URL: | |
Notes: | Export Date: 21 May 2015 -- Source: Scopus |