The Effectiveness of Adjuvant Chemotherapy in the Transitional Cell Carcinoma of Urinary Bladder with Lymph Node Involvement Treated by Radical Cystectomy / 대한비뇨기과학회지

ABSTRACT

PURPOSE: To assess the impact of adjuvant chemotherapy on the survival of patients treated surgically for a bladder transitional cell carcinoma (TCC). MATERIALS AND METHODS: We retrospectively analyzed the data from 243 patients with bladder TCC who underwent a radical cystectomy. The mean age of the patients was 61.2 years, with a median follow-up of 46.8 months. The influence of prognostic factors, including age, gender, tumor stage, grade and chemotherapy, on the 5-year survival rate were analyzed. The difference in the survival rates among the prognostic factors were analyzed by univariate and multivariate analyses. RESULTS: The overall 5-year survival rate was 72%. The significant prognostic factors for the 5-year survival according to the univariate analysis were lymph node involvement, tumor stage, age and chemotherapy. From the multivariate analysis, lymph node involvement was the most independent of the prognostic factors for survival. Patients with lymph node involvement had a worse prognosis than those without (p<0.001). Adjuvant chemotherapy in patients with lymph node involvement had a great impact on survival (p=0.001). CONCLUSIONS: When treating a bladder TCC with a radical cystectomy, lymph node involvement, tumor stage, age and chemotherapy were significant factors influencing survival. Adjuvant chemotherapy will provide a therapeutic role in invasive bladder TCC, with lymph node involvement, following a radical cystectomy.