Analysis Invasive Bladder Cancer Bladder Retention Comprehensive Therapy

ObjectiveTo evaluate the therapeutic effect of bladder-sparing therapy combined with chemotherapy and radiotherapy for muscle invasive bladder cancer (MIBC).MethodsData of72patients with MIBC from January2003to August2010, including42cases of MIBC underwent bladder-sparing treatment, and30cases underwent radical cystectomy were analyzed retrospectively. Of the42patients,28underwent partial cystectomy;14underwent TURBT;5underwent radiotherapy because of incomplete resection or positive resection margines.All these42patients maintained chemotherapy..Kaplan-meier method and Log-rank test were used to analyze overall survival.ResultsA total of72patients with MEBC were followed up for12to92months(mean43.1months,median50months),including54males and18females,with a median age of67.3(range40to85).In bladder-sparing group,localised relapse occured in24patients(16non-muscle invasive relapse,8muscle-invasive relapse).6muscle-invasive relapse were treated with TUBBT or PC,combined with chemotherapy or radiotherapy.1patient was treated with salvage RC.1patient was treated with palliative TURBT.In the bladder-sparing treatment group,the mean survival time was50.721months,the median was47months.In the RC group the mean survival time was57.540months,the median was52months. During the follow-up of12-92months,34patients died,including21cases (50%) underwent bladder-preserving treatment and13cases(43%) underwent radical resection.The survival rate of bladder-preserving treatment group after1,2,3,4,5year were88.1%、83.3%、61.9%、57.1%、47.6%, respectively, and the radical resection group were86.7%、80.0%、66.7%、63.6%、53.3%. There was no significant diferrence between the two groups(P>0.05). Conclusions1、PC or TURBT combined with chemotherapy or radiotherapy for the treatment of MIBC can reach a similar survial rate with that of radical cystectomy.2、 Multimodality bladder-preserving treatment is a reasonable choice for the patients who refuse RC or can not tolerate RC because of bad physical condition.