Yaşar BEDÜK, Gül ERGÜN, Sümer BALTACI, Kadir TÜRKÖLMEZ, Cağatay GÖĞÜŞ, Berkan REŞORLU

Analysis of prognostic factors in bladder carcinoma treated with radical cystectomy

Amaç: İnvaziv mesane tümörlerinin tedavisinde bugün için standart tedavi yöntemi radikal sistektomidir. Bu çalışmada, invaziv mesane kanseri nedeniyle radikal sistektomi yapılan 241 hastadaki cerrahi deneyimlerimiz ve uzun dönem takip sonuçlarımız sunulmaktadır. Materyal ve Metodlar: Kliniğimizde 1990 yılından itibaren invaziv mesane kanseri nedeniyle radikal sistektomi yapılan 241 hastanın (214 erkek, 27 bayan) kayıtları retrospektif olarak incelenmiştir. Klinik ve patolojik verilerle birlikte, hastaların takip sonuçları da değerlendirilmiştir. Kategorik değişkenler arasındaki ilişkilerin araştırılmasında ki-kare testi kullanılmıştır. Sağkalım oranları Kaplan-Meier metodu ile, hastaların özellikleri ve sağkalım arasındaki ilişki de log-rank testi kullanılarak belirlenmiştir. Bulgular: Üriner diversiyon tipi olarak 97 hastaya ileal konduit, 58 hastaya ileum segmenti ile ortotopik üriner diversiyon, 43 hastaya mainz pouch II, 22 hastaya üreterokutanostomi ve 21 hastaya ise üreterosigmoidostomi uygulanmıştır. Hastaların ortalama yaşı 59.8 (29 ve 83 yıl arasında) yıldır. Patolojik evrelere göre 5 yıllık genel sağkalım oranları pT0, pT1, pT2, pT3 ve pT4 için sırasıyla %72.9, %77.6, %48.0, %25.4 ve %28.8 olarak tahmin edilmiştir (Şekil 1; log-rank test, p

Mesane kanserinde radikal sistektomi sonrası prognostik faktörlerin değerlendirilmesi

Aim: To evaluate variable prognostic factors which might aff ect disease-specific survival in patients who have undergone radical cystectomy and pelvic lymphadenectomy for bladder carcinoma. Methods: We retrospectively reviewed 241 consecutive patients with invasive bladder carcinoma between 1990 and 2008, all had radical cystectomy. The clinical and pathological data and clinical outcome were evaluated. The Chi-square test was used to determine the significance of the relationship between the clinical and pathological findings. While disease-specific survival and the association between patient`s parameters and survival were analyzed using Kaplan-Meier method and long-rank test respectively. Results: Considering the type of urinary diversion, 97 patients had ileal conduit; 58 patients had orthotopic bladder using ileal segment; and orthotopic mainz pouch was applied to 43 patients. While ureterocutaneostomy and ureterosigmoidostomy were the choice in 22 and 21 patients respectively. The mean age of the patients at receipt of the surgical procedure was 59.8 years (range from 29 to 83 years) and the mean follow-up interval was 34 months (median follow up: 22, SD: 36.66; range from 1 to 175) for patients alive at last follow-up. According to the pathological stage, the 5-year survival rate was found to be 72.9%, %77.6%, 48.0%, 25.4% and 28.8% for pT0, pT1, pT2, pT3 and pT4 respectively. (Figure 1; log-rank test, p

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