Background and objective: Radical cystectomy and urinary diversion is universally accepted as the most effective treatment for muscle invasive bladder cancer, but the operation is complicated, time-consuming and causes many complications. This study was to summarize our experience and clinical outcomes of modified radical cystectomy in the treatment of patients with muscle invasive bladder cancer.
Methods: In total 188 patients with invasive bladder cancer treated in the Department of Urology, Sun Yat-sen University Cancer Center from January 2000 to December 2007 with modified radical cystectomy and urinary diversion were analyzed retrospectively. Patients were followed up for 2 to 97 months, with a median of 31 months.
Results: The operative time was 120-525 min, with a median of 300 min. Blood transfusion was required in 39.9% of the patients. There was no operation-related death. The 5-year recurrence free and 5-year overall survival rates were 74.9% and 71.5%, respectively. The 5-year and overall survival were 82.5% and 82.8% for patients with organ-confined bladder cancer, 19.0% and 34.3% for patients with extravesical extension of bladder cancer, 82.2% and 79.1% for lymph node-negative patients, and 25.2% and 11.4% for lymph node positive patients.
Conclusions: Modified radical cystectomy and urinary diversion is an effective and safe approach in treating muscle invasive bladder cancer. The efficacy of radical cystectomy is limited for the treatment of patients with extravesical extension of bladder cancer and lymph node positive patients.