LONG-TERM FOLLOW-UP OF ALL PATIENTS WITH MUSCLE INVASIVE (STAGES T2, T3 AND T4) BLADDER-CARCINOMA IN A GEOGRAPHICAL REGION

Purpose: We studied the relationship between long-term survival and tr eatment of stages T2, T3 and T4 bladder carcinoma in an unselected pat ient population.Materials and Methods: A total of 680 patients with th e initial diagnosis of bladder carcinoma in 1987 to 1988 in Western Sw eden was prospectively registered and followed until 1994. Of these pa tients 107 had stage T2 to T3 and 41 had stage T4 disease. Results: Of the patients with stage T2 to T3 disease 30 (mean age 66) underwent r adical cystectomy, 33 (mean age 75) full dose radiotherapy and 44 (mea n age 81) nonradical therapy (mainly transurethral resection of the bl adder). The 5-year crude survival rates were 33, 15 and 14%, respectiv ely. Of the patients with stage T4 disease 6 (mean age 61) underwent r adical cystectomy, 9 (mean age 73) full dose radiotherapy and 26 (mean age 81) nonradical therapy (mainly transurethral resection of the bla dder). All except 1 patient died of disease within 4 years. Conclusion s: More than 60% of the patients in the cohort were considered unsuita ble for radical cystectomy and their survival was poor, whether treate d with full dose radiotherapy or transurethral resection of the bladde r alone.