PURPOSE: To validate the current TNM staging system, we analyzed our contemporary experience with 300 cystectomies. MATERIALS AND METHODS: The pathological material and medical records of 300 patients treated with cystectomy were reviewed, and the new TNM classification was adopted. RESULTS: The median followup of patients with no evidence of disease was 65 months, and overall survival rate was 45% with a median survival of 50 months. In a Cox regression analysis only patient age, pT stage and neoadjuvant chemotherapy were significant factors for survival. The disease specific survival was 67% with a median survival of 94 months. In a multiple proportional hazards analysis only pT stage and previous chemotherapy were significant factors of disease specific survival. A significant difference was seen in the overall and disease specific survival between patients with organ confined and nonorgan confined tumors. We did not observe a difference in the survival rate among patients with pT4a to pT3 tumors. Significant differences were not seen in survival rates between sexes or among patients of different age groups. Transitional cell carcinoma was the predominant histological type, and no significant difference was found in patient outcome among the different histological subtypes. CONCLUSIONS: Bladder cancer can be categorized into organ confined and nonorgan confined tumors. This dichotomous grouping is better suited for evaluating adjuvant clinical trials. The pT stage of the bladder and prostate should be prospectively analyzed together to better define the clinical implications of prostatic involvement. In our opinion the histological subtypes do not affect outcome.
PURPOSE: To validate the current TNM staging system, we analyzed our contemporary experience with 300 cystectomies. MATERIALS AND METHODS: The pathological material and medical records of 300 patients treated with cystectomy were reviewed, and the new TNM classification was adopted. RESULTS: The median followup of patients with no evidence of disease was 65 months, and overall survival rate was 45% with a median survival of 50 months. In a Cox regression analysis only patient age, pT stage and neoadjuvant chemotherapy were significant factors for survival. The disease specific survival was 67% with a median survival of 94 months. In a multiple proportional hazards analysis only pT stage and previous chemotherapy were significant factors of disease specific survival. A significant difference was seen in the overall and disease specific survival between patients with organ confined and nonorgan confined tumors. We did not observe a difference in the survival rate among patients with pT4a to pT3 tumors. Significant differences were not seen in survival rates between sexes or among patients of different age groups. Transitional cell carcinoma was the predominant histological type, and no significant difference was found in patient outcome among the different histological subtypes. CONCLUSIONS:Bladder cancer can be categorized into organ confined and nonorgan confined tumors. This dichotomous grouping is better suited for evaluating adjuvant clinical trials. The pT stage of the bladder and prostate should be prospectively analyzed together to better define the clinical implications of prostatic involvement. In our opinion the histological subtypes do not affect outcome.
Authors: Raymond H Mak; Daniel Hunt; William U Shipley; Jason A Efstathiou; William J Tester; Michael P Hagan; Donald S Kaufman; Niall M Heney; Anthony L Zietman Journal: J Clin Oncol Date: 2014-11-03 Impact factor: 44.544
Authors: Henning Reis; Rene Serrette; Jennifer Posada; Vincent Lu; Ying-Bei Chen; Anuradha Gopalan; Samson W Fine; Satish K Tickoo; Sahussapont J Sirintrapun; Gopa Iyer; Samuel A Funt; Min Yuen Teo; Jonathan E Rosenberg; Dean F Bajorin; Guido Dalbagni; Bernard H Bochner; David B Solit; Victor E Reuter; Hikmat A Al-Ahmadie Journal: Am J Surg Pathol Date: 2019-07 Impact factor: 6.394
Authors: Faysal A Yafi; Armen G Aprikian; Joseph L Chin; Yves Fradet; Jonathan Izawa; Eric Estey; Adrian Fairey; Ricardo Rendon; Ilias Cagiannos; Louis Lacombe; Jean-Baptiste Lattouf; Fred Saad; David Bell; Darrel Drachenberg; Wassim Kassouf Journal: World J Urol Date: 2013-11-10 Impact factor: 4.226