The Clinical Study Of Invasive Bladder Cancer Combined Treatment To Keep The Bladder

Objective:To evaluate the efficacy of invasive bladder cancer in three treatment programs, to analyze the advantages and disadvantages of three treatment options and to discuss whether to retain the bladder comprehensive treatment for invasive bladder cancer can become a feasible and reasonable treatment except the radical resection of the bladderMethods:144primary invasive bladder cancer patients entered this trial, who were in my hospital during May2002-May2007, Clinical stage:T2N0M072cases and T3N0M072cases. The trial was divided into three groups:combined treatment group, bladder instillation group and the radical group, the indicators of three groups were analyzed in order to draw conclusions.60patients with preservation bladder surgery alone were grouped into bladder instillation group:46men(average,54.5years) and14women (average,60.5years),T2N0M031cases and T3N0M029cases、TCC60cases、 pathological stage:grade Ⅰ22cases、grade Ⅱ24cases and grade Ⅲ14cases、reserved the bladder surgery and routine postoperative instillation of Pirarubicin or HCPT for6months or more.40patients underwent retention bladder surgery, postoperative chemotherapy with gemcitabine and cisplatin in patients were grouped into integrated group:29men(average,55.5years)and11women(average,61.5years)、T2N0M018cases and T3N0M022cases、40TCC cases、pathological stage:grade112case、grade Ⅱ16cases and grade Ⅲ12cases、reserved the bladder surgery、routine postoperative instillation of Pirarubicin or HCPT for6months or more and postoperative intravenous chemotherapy with gemcitabine and cisplatin ranging from2to6cycles (gemcitabine,800-1000mg/m21,8,15days of intravenous infusion, cisplatin 70mg/m2intravenously on day2and4weeks for a cycle).44patients underwent radical surgery were grouped into radical group:32men(average,56.5years) and12worn en(average,62.5years)、T2N0M023cases and T3N0M021cases、44TCC cases.pathological stage: grade I9cases, grade II20cases and grade III15cases. The difference of three groups in gender, age, tumor size, and recurrence, clinical stage, pathological stage and histological type was not statistically significant (P>0.05).Table1. The difference was compared of three different treatment regimens in3-year overall survival、clinical stage of the same3-year survival situation、time to first relapse、local recurrence、metastasis, health-related quality of life score and postoperative complications.Results:1. bladder instillation group3-year overall survival rate and the different clinical stages of3-year survival rate:39.29%, T2N0M042.86%, T3N0M039.26%; combined treatment group3-year overall survival rate and different clinical stages3-year survival rate:70.27%, T2N0M075.00%, T3N0M066.67%; the radical group3-year overall survival rates and different clinical stages3-year survival rate:75.61%, T2N0M080.00%, T3N0M071.24%; The comparison of bladder instillation group and combined treatment group is statistically significance (P <0.05), bladder instillation group and the radical group is statistically significance (P <0.05) and combined treatment group and the radical group is not statistically significant (P>0.05).2.The overall three years recurrence rate of cancer for:69.64%、bladder instillation group,32.43%、combined treatment group, statistical analysis between the two groups: P <0.053.The comparison of bladder instillation group and the combined group in the operation time、blood loss、postoperative hospital stay、and complications is similar to the basic:P>0.05, while the radical group is significantly higher than the first two groups:P<0.054. The quality of life of combined therapy group and bladder instillation group is no difference:P>0.05, combined treatment group and bladder instillation group is significantly higher than the radical group:P<0.05.Conclusions:1. For invasive bladder cancer (T2N0M0, T3N0M0), the comprehensive treatment of retaining bladder surgery+GC,which chemotherapy side effects is light, can improve the quality of life and the recent results were satisfactory, it is reasonable and effective.2. To retain the bladder comprehensive treatment for invasive bladder cancer(T2N0M0, T3N0M0) can become a feasible and reasonable treatment except the radical resection of the bladder...