Radical cystectomy for treating bladder cancer: oncological outcome in 271 Chinese patients
Zhang ZL, Dong P, Li YH, Liu ZW, Yao K, Han H, Qin ZK, Zhou FJ. Chin J Cancer. 2013 Aug 6. doi: 10.5732/cjc.012.10312. [Epub ahead of print]


State Key Laboratory of Oncology in South China; Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, P. R. China. zhoufj@mail.sysu.edu.cn.


Few large scale studies have reported the oncological outcome of radical cystectomy for treating bladder cancer in China; hence, we lack long-term prognostic information. The aim of the current study was to determine the survival rate and prognostic factors of patients who received radical cystectomy for bladder cancer in a Chinese medical center. We retrospectively analyzed clinicopathologic data from 271 bladder cancer patients who underwent radical cystectomy between 2000 and 2011. Univariate and multivariate analyses were conducted to identify independent prognostic predictors for this cohort. Median follow-up was 31.7 months (range, 0.2--139.1 months). Thirty-day mortality was (1.4%). The 5-year recurrence-free survival, cancer-specific survival (CSS), and overall survival were 61.6%, 72.9%, and 68.0%, respectively. The 5-year CSS of patients with T1--T4 disease was 90.7%, 85.0%, 51.0%, and 18.0%, respectively. Patients with organ-confined disease had a higher 5-year CSS than those with extravesical disease (81.4% vs. 34.9%, P < 0.001). For the 38 patients (14%) with lymph node involvement, the 5-year CSS was 27.7%--significantly lower than that of patients without lymph node metastasis (P< 0.001). The 5-year CSS was much higher in patients with low grade tumor than in those with high grade tumor (98.1% vs. 68.1%, P < 0.001). Multivariate Cox regression showed that patient age (hazard ratio, 2.045; P = 0.013) and T category (hazard ratio, 2.213; P < 0.001) were independent predictors for CSS. These results suggest that radical cystectomy is a safe and effective method for treating bladder cancer in Chinese patients. High age and T category were associated with poor prognosis in bladder cancer patients who received radical cystectomy.