Factors Affecting Outcome in Patients Treated with Radical Cystectomy for Locally Advanced Bladder Cancer

Abstract

Radical cystectomy is the golden standard treatment of an invasive disease ?.s it offers the best and most durable local control with low mortality, acceptable treatment related morbidity, and suitable quality of life. However, approximately 50% of the patients with a muscle invasive continue to die within the next 5 years following cystectomy, mainly because of distant disease relapse.

In this these we have evaluated the impact of several pathological and surgical factors on outcome of bladder cancer patients treated with radical cystectomy aiming to explore their potential clinical applicability in identifying patiL:nts at risk who may require an additional therapy in conjunction with cystectomy. We have also evaluated the technical feasibility of laparoscopic radical cystectomy in comparison to its counterpart, open radical cystectomy.

f.'our hundred and thirty two male patients treated with radil:al cystectomy in the period between January 1990 and January 2004 at Urology department, Tanta University Egypt, and at the Brady Urological Institute, Johns Hopkins Nledical Institutes, United States formed the basis of this thesis.

The mean patient age was 62.2 years. Hematuria was the most common presentinr symptom (331 pts, 76.7%) in our bladder cancer population (gross hematuri:l in 243 pts & microscopic hematuria in 88 pts). Urothelial (transitional cell) c 1rcinoma was the most common histopathologic tumor type (3R4 pts, 88.8%).