Ortega MBA, Obaldia CG, Galindo OJ

Language: Spanish
References: 17
Page: 363-368
PDF size: 196.30 Kb.

ABSTRACT

Bacground: According to the Mexican Histopathologic Malignant Neoplasia Registry, in the year 2000 the mortality rate due to bladder cancer was 1.12 per 100,000 persons.
Objective: To report the experience in treatment and follow up of 50 patients with bladder cancer diagnosis is reported.
Materials and methods: Clinical files of patients with bladder cancer, treated in the Oncology Service of CMN 20 de Noviembre, from January 1996 to December 2001 were revised. There were found 50 valid cases with histological corroboration of bladder cancer. They were classified according to Jewett-Marshall System and the survival curve was calculated according to Kaplan-Meier Method.
Results: Patients were 35 men (70%) and 15 women (30%). The age range was between 43 and 92 years with a mean of 69 years. In stage 0 there were 14 patients, in stage A, 8; in stage B1, 2, in stage B2, 14: in C, 7 and in D2, 5. The most frequent symptom was macroscopic hematuria in 92% of the patients. Diagnostic was established with biopsy by cystoscopy or vesical mapping in all the cases. The histological types were: transitional cell carcinoma in 45 patients (90%), papilar carcinoma in 2 patients (4%), adenocarcinoma in 2 patients (4%) and utorelial carcinoma in 1 patient (2%). Tumor grading was ASH I in 16 cases, ASH II in 19 and ASH III in 15. the treatment depended on the stage: patients in stage 0 and A got intravesical BCG, in stage B1 radiotherapy was administered. In stage B2, 20 Gys of preoperatory external radiotherapy was administered followed by a radical cystectomy, making several urinary derivation being the ileal conduct (Bricker) the most frequent. In stage C they received 20 Gys pre-operatory radiotherapy followed by surgery: radical cystectomy in 4 patients and simple cystectomy in 3 patients. In stage D2, they received bladder radical radiotherapy, in one of them also a simple cystectomy with ileal conduct was practiced and to another one only the ileal conduct was practiced. The real survival up to December 2001 cut in stage 0 was in range from 12 to 60 months, 10 patients live without tumoral activity and 4 died without tumoral activity; in stage A the survival range was from 16 to 60 months, 4 live without tumoral activity, 1 with tumoral activity; 2 of them died without tumoral activity and 1 with tumoral activity. In stage B1 the survival range was of 9 and 12 months alive without tumoral activity, in stage B2 the survival range was between 4 and 51 months, 8 of them live without tumoral activity, 1 with tumoral activity, 6 of them died with tumoral activity and one without it. In stage C the survival range was from 1 to 42 months 3 are alive without tumoral activity and 4 died with tumoral activity. In stage D2 the survival range is from 3 to 9 months and all patients died with tumoral activity.
Conclusions: Most part of the patients were found in invasive stages, the patients who have more survival time are the ones of early stages. The radical surgery is the most indicated procedure in case of deep muscular invasion.

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