ABSTRACT
In the Saguenay-Lac-Saint-Jean area, an abnormal incidence of bladder cancer bas been identified. This incidence is an effect of the important industrial environment and the etiology has been identified. A review of the surgical treatment is actually done. Following this evaluation, we have made a choice in our medical environment (the ileal conduit or the detubularised ileal bladder for a replacement after a radical cystectomy). For the 1970 to 1997 period, a statistic statement has been done and shows the patients survival in accordance with the grade and the stage. A more appropriate treatment should be given in T3A and T3B stages. In conclusion, we have instituted a group of stimulus in the industrial environment to improve the survival for the next decades.
Subject(s)
Cystectomy/methods , Urinary Bladder Neoplasms/surgery , Urinary Bladder/surgery , Urinary Diversion/methods , Environmental Pollutants/adverse effects , Female , Humans , Male , Neoplasm Staging , Quebec/epidemiology , Survival Analysis , Urinary Bladder Neoplasms/drug therapy , Urinary Bladder Neoplasms/epidemiology , Urinary Bladder Neoplasms/etiology , Urinary Bladder Neoplasms/pathologyABSTRACT
Bladder cancer is more frequent in Quebec, especially in Saguenay-Lac Saint-Jean than in other Canadian provinces and in the USA. From 1983 to 1996, only 78 patients presenting with bladder cancer received external beam radiation therapy. Sixty-eight were treated with curative intent. Overall survival rates were 70% at 3 years, 66% at 5 years, and 40% at 10 years. Retrospective analysis of these cases and literature review show that preoperative radiation therapy is useful in the management of bladder cancer, especially in T3 tumors. It is also useful for patients whose tumor objectively responds to radiation therapy, without an increase in morbidity.
