[Prognostic factors for survival in patients with transitional bladder cancer treated with radical cystectomy]. / Factores pronósticos en la supervivencia de los pacientes con carcinoma transicional de vejiga tratados con cistectomía radical.

PURPOSE: To recognize clinical and pathological variables that influence in bladder cancer specific mortality in patients with transitional bladder cancer treated with radical cystectomy. MATERIAL AND METHOD: Retrospective analysis of 333 patients with transitional bladder cancer treated with radical cystectomy. Variables included during pre-cystectomy, peri-cystectomy and post-cystectomy period were analyzed. Four groups were defined based on pathological state: a) Organ-confine bladder cancer without lymph node metastasis (pT0-2, pN0); b) Extravesical desease without lymph node metastasis (pT3-4, pN0); c) Bladder cancer with lymph node metastasis (pT0-4, pN+); d) No data of lymph node affection (pT0-4, pNx). Univariate analysis and two models of multivariate analysis were performed including the risk group as a variable in one the latest. RESULTS: Mean follow up was 52.6 +/- 51 (2-221) months with a median of 31 months. Pathological state pT0 was observed in 7.2% of the patients, 12% were pT1, 26.7% pT2, 34.5% pT3 and 10.5% pT4. Lymph node metastasis was detected in 20.7% of the patients. Lymph node metastasis increased according to pathological state rises. Five and 10 years specific survival was 57% and 54% respectively. CONCLUSIONS: Local pathological state, lymph node status and risk groups were independent predictive factors for bladder cancer specific survival. Risk group association is a reliable method to predict bladder cancer specific survival and to identify the suitable patient group to get benefit from adjuvant therapy.