چکیده (انگلیسی):

Objective: To compare the survival outcome of various treatment modalities for
organ-confined muscle-invasive urothelial carcinoma of the bladder.
Methods: One hundred and fifty patients with Stage II (T2, N0, M0) or Stage III (T3a-T4a, N0,
M0) urothelial carcinoma of the bladder treated at the National Referral Hospital and the National
Cancer Center of Indonesia from 1995 to 2010 with a minimum follow-up period of 24
months were included in this study. Overall survival and mean survival times were analyzed using
the KaplaneMeier method.
Results: The mean
standard deviation age of the patients in this study was 57.15
11.6
years and 88% were men. Over 50% of patients had T2 disease, 24.2% had T3 disease, and
21.5% had T4 disease based on pathology. Based on histological grade, 30.8% were intermediate
grade tumors and 42.1% were high-grade tumors. Radical cystectomy was performed in 20
patients (13.3%) and 40 patients (26.7%) were treated with radiotherapy. Ninety (60%) patients
underwent transurethral resection of the bladder tumor only without further definitive treatment
for personal reasons. The actuarial 5-year overall survival for all patients was as follows:
radical cystectomy, 50%; radiotherapy, 22.7%; and transurethral resection of the bladder tumor
only, 8.3% (log-rank p Z 0.029). For stage T2 patients, the 5-year overall survival was:
radical cystectomy, 62.5%; radiotherapy, 31.2%; and transurethral resection of the bladder tumor
only, 8.3% (log-rank p Z 0.017).
Conclusion: In our series, radical cystectomy had a superior outcome to radiotherapy or transurethral
resection of the bladder tumor only, comparable with results reported elsewhere.
Radical cystectomy should be offered as the gold standard treatment for organ-confined muscle-invasive
urothelial carcinoma of the bladder.