Prognostic factors in a recent series of patients treated with radical cystectomy for bladder cancer.

OBJECTIVE: To identify the clinical and pathological prognostic factors in a homogeneous series of patients with bladder cancer who had undergone radical cystectomy in the late 1990s. MATERIALS AND METHODS: We retrospectively analyzed the clinical data of 156 patients who had undergone radical cystectomy and iliac-obturator lymphadenectomy for bladder carcinoma at our department between 1995 and 2001. RESULTS: The mean follow-up was 39.71 +/- 26.2 months. The 5-year overall and cancer-specific survival rates were 47.2 and 54.7%, respectively. Upper urinary tract obstruction (p = 0.03), clinical stage of both the primary tumor (p = 0.0001) and loco-regional lymph nodes (p = 0.04), pathological stage (2002 TNM) of the primary tumor (p < 0.0001), pathological loco-regional lymph node involvement (p < 0.0001), and vascular embolization (p = 0.005) were significant on univariate analysis. Pathological lymph node involvement (p = 0.001) and both pathological (p = 0.022) and clinical stages of the primary tumor (p = 0.002) turned out to be independent predictors of cancer-specific survival. CONCLUSION: Pathological lymph node involvement, clinical and pathological stage of the primary tumor were the cancer-specific, survival-independent, predictors in our series. Our multivariate analysis data identified pT3-4 and pN+ patients as those with the worst prognosis.