Shahzad Ali, Muhammad Mansoor, Iqbal Shahzad.
Radical Cystectomy in patients with Transitional Cell Carcinoma Urinary Bladder.
J Surg Pak Jan ;22(2):47-50.

Objective: To find out various presentations, types of operations performed, perioperative complications, pathological staging and oncological outcome of patients with transitional cell carcinoma (TCC) urinary bladder treated with radical cystectomy. Study design: Descriptive case series. Place & Duration of study: Department of Urology Jinnah Postgraduate Medical Centre Karachi, from January 2009 to December 2014. Methodology: All patients who underwent radical cystectomy with bilateral pelvic iliac lymphadenectomy due to muscle invasive transitional cell carcinoma of bladder with or without adjuvant or neo-adjuvant chemotherapy or radiotherapy from January 2009 to December2014 with minimum of two years follow up, were included in the study. Patients with proven metastasis were excluded. Clinical presentations, details of surgeries, post-operative complications, pathological staging and oncological outcomes were recorded. Results: Thirty-two patients were operated. Age ranged from 35 to 70 year. There were.28 males (87.5%) and 04 females (12.5%) patients. Painless hematuria was the most common clinical presentation. Most (81.2%) of the patients were diagnosed as muscle invasive transitional cell carcinoma on first trans-urethral resection of bladder growth (TURBT). Radical cystectomy with standard pelvic lymph node dissection (PLND) and ileal conduit were performed in all patients. Two (6.2%) patients died in perioperative period. Fourteen (43.8%) patients developed complications. Pathological staging revealed non-organ confined disease with positive lymph node in six (18.6%) patients. Disease free survival (DFS) was noted in 68.7% of patients. Over-all survival was 65.6%. Conclusion: Radical cystectomy in patients with potentially invasive or invasive TCC bladder helped in achieving long term survival in majority of the patients.

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