The Clinical Analysis of Transurenthral Resection Therapy for Muscle Invasive Bladder Cancer.

Objective To compare the transurenthral resection to radical cystectomy on muscle invasive bladder cancer, and to explore the factors affecting the prognosis. Methods Data of 74 patients with muscle invasive bladder cancer were retrospectively analyzed. There were 38 cases underwent radical cystectomy (group A), and were treated with intravenous chemotherapy after operation. There were 36 cases underwent transurenthral resection (group B), and were treated with intravenous and urinary bladder irrigation chemotherapy. All patients were followed up 61 (5-91) months. Data were compared between two groups including duration of surgery, intraoperative blood loss, the cumulative length of hospital stay, cancer recurrence rate and 5-year survival rate . The factors may affecting the prognosis in patients were collected and analyzed by the Log-rank univariate and Cox multivariate analyzed. Results The values of operation time, intraoperative blood loss and the cumulative length of hospital stay were significantly lower in group B than those of group A (P < 0.01). There were no significant differences in cancer recurrence rate and 5-year survival rate between two groups (P > 0.05). Results of the Log-rank univariate analysis showed that the tumor size ≥5 cm and T3 stage were the important factors of 5-year relapsefree survival rate and 5-year overall survival rate. Results of the Cox multivariate analysis showed that the tumor size ≥5 cm (RR=3.687, 95%CI:1.913-7.105, P < 0.001) was the important factor of recurrence in patients after operation. T3 stage (RR=3.325, 95%CI:1.437-7.695, P=0.005) and tumor size 3=5 cm (RR=5.017, 95%CI:2.440-10.317, P=0.002) were the risk factors of the 5-year overall survival rate. Conclusion The transurenthral resection with intravenous and urinary bladder irrigation chemotherapy deserves recommendation for the treatment of muscle invasive bladder cancer. Tumor size ≥5 cm and T3 stage are the important factors for the prognosis. [ABSTRACT FROM AUTHOR]