Evaluation Of The Efficacy Of Combined Bladder-preserving Therapy And Radical Cystectomy For Muscle Invasive Bladder Cancer?T₂N₀M₀?

Objective Comparison of survival rate and postoperative quality of life in patients with muscle invasive bladder cancer?T₂N₀M₀?treated with combination therapy and radical cystectomy,and to explore the feasibility of comprehensive treatment of bladder preservation to reduce the recurrence,prolong the survival time and improve the quality of life of patients.Method Objective to retrospectively analyze and compare the bladder cancer patients in Department of Urology in our hospital from January 2003 to June 2011.A total of 279 patients with T₂N₀M₀ who met the inclusion criteria were enrolled.Comprehensive treatment of 162 cases of bladder preservation,transurethral resection of bladder tumor + internal iliac artery infusion chemotherapy + intravesical chemotherapy group?group A?and 117 cases of radical cystectomy group?group B?of muscle invasive bladder cancer?T₂N₀M₀?patients after treatment for 1 years,3 and5 year survival rate,compared the quality of life and postoperative evaluation of the survival curve.Result Results from the 279 patients enrolled in the study,the results showed that the A group of patients with muscle invasive bladder cancer?T₂N₀M₀?,their survival rate of 1 years,3 years and 5year was about 94.44%?153/162?,79.63%?129/162?,and 62.96%?102/162?respectively.In the B group of patients with muscle invasive bladder cancer?T₂N₀M₀?,their survival rate of 1 years,3 years and 5year was about 94.87%?111/117?,76.92%?90/117?and 64.10%?75/117?,respectively.There was no significant difference in the 1 year survival rate,3 year survival rate and5 year survival rate of the patients between the two groups?P > 0.05?.The survival time of the patients with A and B was summarized and the Kaplan-Meier survival curve was drawn.The data were analyzed by Log-Rank test and Breslow test.The results showed that the survival rate of the two groups was not statistically significant?P > 0.05?.The life quality of two groups of patients with muscle invasive bladder cancer?T₂N₀M₀?were evaluated.The results showed that the general health status score with two group was 63.12±11.69 ? 35.68±8.47.The overall health status of patients in group A was better than that of B group,and difference between the two groups was statistically significant?P < 0.05?.In the functional domain,the A group had higher quality of Somatic function?PF?,role function?RF?,emotional function?EF?,and cognitive function?CF?compared with the B group,the difference was statistically significant?P < 0.05?.In the field of symptoms and individual items,There was a significant difference between the two groups of fatigued?FD?,nausea vomiting?NV?,pain?PA?,insomnia?SL?and constipation?CO?,the difference was statistically significant?P < 0.05?.Conclusion In patients with muscle invasive bladder cancer?T₂N₀M₀?,there was no significant difference in survival rate between patients with bladder cancer treated and radical cystectomy when the indications were strictly selected,but the comprehensive treatment of bladder preservation is superior to radical cystectomy in the postoperative quality of life.