20. NATIONAL CONGRESS OF UROLOGY - 20. ULUSAL ÜROLOJİ KONGRESİ

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Research Title: 
Radical Cystectomy For Primary Bladder Malignancy: What Changed In The Last Years Purpose
Authors: 
Ugur Balc
Authors: 
Mahmoud Mustafa
Authors: 
Ertugrul Sefik
Authors: 
Kutlu Teberik
Authors: 
Cetin Dincel
Authors: 
Cengiz Girgin
Country: 
Turkey
Date: 
Sat, 2008-11-01
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Radical_Cystectomy_For_Primary_Bladder_Malignancy_What_Changed_In_The_Last_Years_Purpose.pdf1.27 MB
Research Abstract: 

PURPOSE: Radical cystectomy(RC)is universally accepted as the definitive treatment for muscle invasive bladder cancer. We evaluated our experience in RC in the first and last five-years.
MATERIAL-METHODS: Records of 138(first group)patients treated with RC for biopsy-proven bladder carcinoma between 1993 and 1997were reviewed and compared with the records of 121(second group)patients treated with RC between the 2003 and 2007. The mean age of both groups were 60.12 and 60.95 years respectively(p=0.23). The numbers of female patients were 13 and 8 in each group respectively(p=0.42). The mean follow up periods for both groups were 25.4 and 17.72 months respectively.
RESULTS: Stages in the second group were more advanced than the stages in the first group(p=0.016). The percentage of the non-urethelial carcinoma increased from 12.4%(first group) to %21(second group)(p=0.06). Five- year disease specific survival for the first and second group were %47 and %55 respectively(p=0.17). While % 26.1 of the diversions were continent in the first group, %57.5 of the diversions were continent in the second group(p=0.17). The percentage of neo-bladder application in the first and the second group were %18.1 and %48.7 respectively. In the second group, three male patients underwent laparoscopic RC and orthotopic neobladder and one female patient underwent laparoscopic RC and uretercutaneostomy.
CONCLUSION: The indications of RC were expanded in terms of stages, histologic diagnosis and urinary diversions. However the survival rates were not negatively effected. This may be due to learning curve and 'the application of new approaches like extended dissection of lymph node and continent diversion