Does early cystectomy improve the survival of patients with high risk superficial bladder tumors?

J Urol. 2001 Oct;166(4):1296-9.

Abstract

Purpose: We compared survival after early versus delayed cystectomy in patients with high risk superficial bladder tumors.

Materials and methods: Of 307 patients with high risk superficial bladder tumors who were treated initially with transurethral resection and bacillus Calmette-Guerin (BCG) therapy 90 (29%) underwent cystectomy for recurrent tumor during a followup of 15 to 20 years. Disease specific survival distribution of these 90 patients was determined relative to the indications for and time of cystectomy.

Results: Of the 90 patients who underwent cystectomy 44 (49%) survived a median of 96 months. Of 35 patients with recurrent superficial bladder tumors 92% and 56% survived who underwent cystectomy less than 2 years after initial BCG therapy and after 2 years of followup, respectively. Of 55 patients with recurrent muscle invasive bladder disease 41% and 18% survived when cystectomy was performed within and after 2 years, respectively. Multivariate analysis showed that survival was improved in patients who underwent earlier rather than delayed cystectomy for nonmuscle invasive tumor relapse.

Conclusions: Earlier cystectomy improves the long-term survival of patients with high risk superficial bladder tumors in whom BCG therapy fails.

Publication types

  • Comparative Study

MeSH terms

  • Adjuvants, Immunologic / therapeutic use
  • Adult
  • Aged
  • BCG Vaccine / therapeutic use
  • Cystectomy*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / mortality*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery*
  • Neoplasm Staging
  • Prognosis
  • Risk Factors
  • Survival Rate
  • Time Factors
  • Urinary Bladder Neoplasms / drug therapy
  • Urinary Bladder Neoplasms / mortality*
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / surgery*

Substances

  • Adjuvants, Immunologic
  • BCG Vaccine