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Radical_Cystectomy_For_Primary_Bladder_Malignancy_What_Changed_In_The_Last_Years_Purpose.pdf | 1.27 MB |
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