Comparative Observation On The Three Minimally Invasive Treatment Methods Of Muscle Invasive Bladder Cancer

Background Although the radical cystectomy(RC)is the gold standard for muscle invasive bladder cancer(MIBC),the high risk during perioperation and operation period cannot be ignore.Meanwhile,the diversion of urine usually lead the patient to poor life quality.These together with the increasing demand of keeping the bladder,continuously improve the micro invasive technique for MIBC therapy which can reserve the bladder.Objective To compare the clinical effect of TURBT,PVBT,LRC respectively combined with chemotherapy treating muscluar invasive bladder cancer.Methods101 patients who were diagnosed as T2-T3N0-1M0 muscular invasive bladder cancer and administrated in Urology surgical of the First and the Third Affiliated Hospital of Xinxiang Medical University during Jan 2009 to Feb 2012: were selected.The patients were assigned to three groups which are TURBT group,PVBT group and LRC group.There are42 patients in TURBT group,31 patients in PVBT group,and 28 patients in LRC group.A retrospective comparison is conducted to analysis the The operation time,intraoperative blood loss,hospital stay and one to five years survival rates.Results1.There is no significant difference between the three groups for subjects of age,gender,body mass index(BMI),TNM stage,tumor size?5cm(P> 0.05).2.The operation time in TURBT group was(62.74±22.39)minutes,PVBT group(30.61±10.39)minutes and LRC group(475.00±62.84)minutes.LRC operation time was significantly longer than the TURBT group and the PVBT group,the difference was statistically significant(P<0.05).3.TURBT group average hospitalization stay was(6.74±1.58)days,PVBT group hospitalization stay(4.74±1.33)days,and LRC group hospitalization stay(30.32±7.05)days.The LRC group hospital stay was significantly longer than the TURBT group and PVBT group,the difference between every two groups was statistically significant(P<0.05).4.The average intraoperative blood loss are(51.62±11.74ml)in group TURBT,PVBT(20.65±6.38ml)and(779.64±122.28ml)in group LRC,the differences between three groups were statistically significant(P<0.05).5.The survival rates after 1,2,3,4 and 5 years are 88.10%,83.33%,64.29%,52.38%,42.86% in TURBT group,and 87.10%,74.19%,62.29%,58.06%,48.39% in PVBT group,and 85.71%,75.57%,64.29%,60.71%,50.00% in LRC group,the differences between three groups were not statistically significant(P> 0.05).6.Results of the Log-rank univariate analysis showed that T3 stage(P<0.05),tumor size?5cm(P<0.05)were the important factors of 5 years survival rate.Conclusions1.This indicated that chemotherapy combined LRC,TURBT and PVBT therapy were effective and feasible.2.The critical reason infuluenced the post-operative survival rate are size over 5centimeters,stage T3 and a higher grade carcinoma.