[Partial cystectomy: and alternative to radical cystectomy? Apropos of a series of 75 patients]

Abstract

From a retrospective series of 75 patients, we try to determine the place of this treatment with respect to bladder urothelial cancer. Of our 75 patients the breakdown of tumours according to their stage is the following: PTA: 16 (21.3%) PT1: 12 (16%) PT2: 21 (28%) PT3 A: 15 (20%) PT3 B: 7 (9.3%) PT4: 4 (5.4%) 47 patients benefited from a complete check up of tumoural spread which is negative in any case. In 28 cases, an uretero-vesical reimplantation was necessary for carcinologic reasons. None of the patients benefited from chemotherapy and/or radiotherapy in pre or post-operative period. Mortality was 4% (3 cases) and morbidity 8% (6 cases)- Sixty two Patients were followed-up at 5 years. The results are expressed according to different carcinologic parameters. The overall rate of recurrence is 61.2% (38/62). The actuarial survival corrected at 5 years, all stages and grades included, is 53.2% (32/62). There was no recurrence in 18 patients (29%) and 29 patients preserved their bladder. The advantages of partial cystectomy are obvious: Its mortality and morbidity are weak. It also preserves the sexual function and mainly avoids resorting to urinary derivations. As a principle these indications apply to a small percentage of invasive tumours T2-T3 A located in the mobile part of the bladder that is unifocal and of small size (< 4 cms).