The accuracy analysis of the factors influencing survival prediction after radical cystectomy

Perepechay V.A., Vasil'ev O.N., Spicyn I.M., Kogan M.I.

Introduction. Despite the progress in complex and combined treatment of urinary bladder cancer (UBC) frequency of recurrence and expansion is still high The results may be improved by the usage of radical cystectomy (RC). But late performance oftheRCguidesto the palliative surgery and does not improve the survival rate

Material and methods. There was performed the analysis of accuracy of the factors influencing survival prediction aer radical cystectomy (RC) by UBCamong 349 patients depending on: stage of UBC; age; among primary and recurrent patients; whetheritis by primary,salvage and palliative cystectomy; time from establishment of the CUB diagnosis till RC procedure; whether there is hydronephrosis caused by blastoma of bladder cancer; whether lesion is multicentric; anemia; comorbidity of patients; on pN and pG statuses; whether there is intransition – cellular carcinoma and CIS.

Results of the research. Significantly worse indexes of all the types of survival are r evealed by palliative RC, which is associated with continued growth of cancer (p=0,00000). e expected general and specific for cancer 3-year survival rate does not exceed 15,4% and 17,1% respectively, with a median survival of 12,0 months.

Discussion. RC by the stage of pT4b and/or with the presence of the distant metathesis requires separate analysis of the results as compared to the results of RC. IF selection of patientsfor RC is effective and estimation of cormobidity and survival prediction is performed, the patients show identical general and cancer specific survival rate regardless of age. Only timely performance of the RC could improve survival rate of the patients with progressive course of UBC.

Conclusion. Significantly negative factors of the prediction influencing general, cancer specific and relapse-free survival of the p atients undergone RC are the stage of UBC (pT), condition of the regional lymph nodes (pN), the stage of cancer differentiation (pG), presence of multicentric lesions of UB, presence of intransition-cellular carcinomas of UB,stage of the initial anemia and the presence of unilateral or bilateral hydronephrosis caused with UBC.

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bladder cancer, radical cystectomy, survival, prognostic factors