Efficacy Of Two Kinds Of Bladder Sparing Surgery For Muscle Invasive Bladder Cancer

Objectives:To evaluate the clinical efficacy of two kinds of bladder sparing surgery for muscle invasive bladder cancer and to explore the prognostic factors of these two kinds of operations.Methods:A total of 84 patients with muscle-invasive bladder cancer(MIBC)were treated with transurethral resection of bladder tumor(TURBT)or partial cystectomy(PC)from January 2009 to October 2013.There are 49 cases(31 cases in T2,14 cases in T3 and 4 cases in T4)in PC group,and 35 cases(31 cases in T2,4 cases in T3 and none in T4)in TURBT group.These patients were outpatient or telephone followed-up for 3 years.Data including the operation time,intraoperative bleeding volume,indwelling catheter time,hospitalization time,complications and recurrence rate in 3 years of each patient was collected and then was used to compare TURBT and PC,analyze prognostic factors related to survival of these two operations.Results:There was significant difference between the two groups in hospitalization time,operation time,intraoperative blood loss,indwelling catheter time(P<0.05),but not the case in complications and 3-year recurrence rate(P>0.05).In PC group and TURBT group,independent risk factors related to tumor survival was pathological stage,(B value was 1.459 and 1.900),respectively.In MIBC group,independent risk factors related to tumor survival rate was pathological stage(B value=1.058)and the numbers of tumor(B value =1.454).During the follow-up period,there were 14 cases(71.4%)and 10 cases(71.4%)died of bladder cancer in PC group and TURBT group,respectively.The 3-year cancerspecific survival(CSS)of the T3 patients in the two groups were 50%and 0%(PC vs.TURBT,P=0.036),respectively.Conclusions:For bladder sparing surgery,TURBT was more suitable for T2 patients,while PC was more suitable for T3-4 patients.Tumor stage was the common independent prognostic risk factor in these two groups,the higher the stage was,the more dangerous of the operation.The lower the stage,the more suitable to do the bladder surgery.