Zusammenfassung
Purpose: T1G3 bladder cancers show the clinical and biological behaviour of muscle invasive tumours with progression rates of about 30%. While radical cystectomy in some cases is indicated, other patients can achieve heating with organ preservation. We present a study anallysing the influence of the risk factors multifocality, tumour diameter > 3 cm and associated carcinoma in situ (Cis) on the ...
Zusammenfassung
Purpose: T1G3 bladder cancers show the clinical and biological behaviour of muscle invasive tumours with progression rates of about 30%. While radical cystectomy in some cases is indicated, other patients can achieve heating with organ preservation. We present a study anallysing the influence of the risk factors multifocality, tumour diameter > 3 cm and associated carcinoma in situ (Cis) on the outcome of initial T1G3 bladder cancers treated in various ways. Materials and Methods: Of 223 patients with initial T1G3 bladder cancer, 125 patients underwent transurethral resection of the tumour JURB), second resection and adjuvant bacille Calmette-Guerin (BCG) instillations (TURB group), 98 patients chose initial radical cystectomy (CX group). Results: Median follow-up times were 56 months JURB group) and 51 months (CX group). 5- and 10-year survival rates (82% and 65% in TURB group vs. 75% and 48% in CX group) did not show statistically significant differences. In Cox regression analysis no single risk factor showed a prognostic value. While in TURB group the combination of all risk factors (multifocality, tumour diameter >= 3 cm and associated carcinoma in situ) was associated with a statistically significantly lower survival rate, the same combination in the CX group was not oncologically relevant. Conclusions: While initial T1G3 bladder cancer with up to two risk factors after organ-preserving therapy is not associated with a lower tumour specific survival rate in comparison to radical cystectomy, patients with a combination of the three analysed risk factors would profit by an early radical cystectomy.
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