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Invasion depth is the most important prognostic factor for transitional‐cell carcinoma in a prospective trial of radical cystectomy and adjuvant chemotherapy
Author(s) -
Mazzucchelli Luca,
Bacchi Marisa,
Studer Urs E.,
Markwalder Regula,
Sonntag Roland W.,
Kraft Rainer
Publication year - 1994
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.2910570104
Subject(s) - cystectomy , medicine , transitional cell carcinoma , urology , bladder cancer , concomitant , stage (stratigraphy) , oncology , carcinoma , univariate analysis , prospective cohort study , chemotherapy , urinary bladder , carcinoma in situ , prognostic variable , survival rate , multivariate analysis , cancer , biology , paleontology
Abstract The aim of this prospective study was to examine the prognostic pathomorphological factors in urothelial cancer of the urinary bladder. Clinical and morphological variables were evaluated by univariate and multivariate analysis in 70 patients with invasive transitional‐cell carcinoma of the bladder (pTI‐pT4a). The patients were treated according to a prospective program consisting of radical cystectomy and pelvic‐node dissection, either alone or followed by adjuvant cisplatinum chemotherapy. Nodal status was pN 0 in 89% of the patients. The median follow‐up time was 5.75 years and the 5‐year survival was 58%. Among the morphologic variables, deep invasion of the bladder wall and squamous differentiation indicated a poorer prognosis. Differentiation grade, pattern of growth (infiltrating versus expanding), angioinvasive growth, glandular differentiation and concomitant prostate carcinoma (pT 1 ) were not significative factors for survival. By contrast, a significant reduction in mortality rate was found in patients with concomitant carcinoma in situ. Multivariate analysis confirmed that depth of invasion is an independent prognostic factor of outcome. The results confirm the primary importance of tumor stage in the prediction of survival after radical cystectomy. © Wiley‐Liss, Inc.