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One hundred and seventy eight patients treated in our clinic were analyzed. The five-year survival rates for the patients (69 cases) given transurethral resection (TUR), total cystectomy (65 cases) and palliative treatment (40 cases) were 92.7%, 61.1% and 3.9%, respectively. The four patients who could not be treated lived no longer than one month. The five-year survival rate for the patients treated with TUR of the tumor was the highest. The recurrence rate for the TUR group was 19.5% at one year, 39.5% at three years and 47.1% at five years after surgery; and, it was higher in the patients with histologically high grade tumors. Generally, we obtained good results with TUR, but total cystectomy had to be performed later on three patients due to progression of the tumor. We felt the need for an indicator to express the biological activity of the tumor, and maintain that regular follow-up by endoscopy and cytology is mandatory. The clinical results of the total cystectomy and urinary diversion were considered to be satisfactory compared to other reports; and, patients with high stage tumor had poor prognosis. Five patients died of progression of the disease after total cystectomy. Operative mortality was 10.7%, which should be decreased by avoiding operative morbidity. In our experience, two-stage operations or preoperative irradiation can increase the indication for total cystectomy; and, improved clinical results are expected.
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