Clinicopathological study and Prognostic Factors in Radical Cystectomy.

Jayanand Sunil, B (2008) Clinicopathological study and Prognostic Factors in Radical Cystectomy. Masters thesis, Cancer Institute (WIA), Chennai.


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Fifty-four thousand new cases of bladder cancer are diagnosed each year. It is the second most common genitourinary cancer and results in over 12,000 cancer-related deaths annually. Twenty percent to 25% of newly diagnosed bladder cancer consist of muscle-invasive disease, with majority of these invasive bladder cancers demonstrating invasion at the time of diagnosis. While tumor grade and stage do influence progression, only approximately 15% of superficial tumors will eventually develop the characteristic features of muscle-invasion. For those that become muscle-invasive, however, the risk of metastasis and mortality unquestionably and dramatically rises. OBJECTIVES : 1. To study the recurrence pattern and disease-free survival of patients undergoing radical cystectomy for bladder cancer. 2. To study the effect of lymphadenectomy on recurrence in bladder cancer after radical cystectomy. 3. To study the prognostic factors governing disease-free survival after radical cystectomy. 4. To do a descriptive analysis of patients undergoing radical cystectomy, to study the morbidity pattern and the quality of life after surgery. MATERIALS AND METHOD : From January 2001 to March 2007, 37 patients underwent radical cystectomy for bladder cancer. These patients were followed up till October 2007. The recurrence pattern and the time to recurrence were studied at follow up. Prognostic factors such as histology, age, grade and stage of the disease that influence the survival and recurrence were studied. The extent of lymphadenectomy and pathological nodal status were correlated with the recurrence. The analysis was done using the SPSS 11.0.1 (15 Nov 2001) statistical package. CONCLUSION : The incidence of bladder cancer is low in India and at the Madras Metropolitan Tumor Registry. Radical cystectomy, performed for muscle-invasive bladder cancer has acceptable morbidity, and level of satisfaction with urinary diversion is satisfactory. Pathological stage of the disease and grade of the tumor has a bearing on the recurrence of the disease. Extent of lymph node dissection and pathological nodal status can prognosticate local recurrence. Extended disease free survival is possible in stage I and stage II disease, and after extensive lymph nodal dissection. High loco-regional failure was observed for N3 disease after surgery, which questions the role of surgery in such a scenario.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Radical Cystectomy ; Prognostic Factors ; Clinicopathological Study.
Subjects: MEDICAL > Surgical Oncology
Depositing User: Kambaraman B
Date Deposited: 26 Jul 2017 02:36
Last Modified: 26 Jul 2017 02:36

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