Efficacy of Bladder-Preserving Therapy for Patients with T3b, T4a, and T4b Transitional Cell Carcinoma of the Bladder

postoperatively for a total of 6 months and completed a follow-up visit every 3 months. The patient survival rate and prognostic factors (age, tumor size, differentiation, number of lesions, stage, and presence of hydronephrosis) were assessed. The Kaplan-Meier method was used to analyze survival rate, and Cox multiple regression analysis was used for prognostic factors. Results: The mean patient age was 68.32±8.6 years, the mean duration of follow-up was 54.70±32.8 months, and the median duration of follow-up was 49.0 months. The 5-year survival rate was 66.2%. Single lesions were found in 28 cases (35.9%), and multiple lesions were found in 50 cases (64.1%). Stage T3b lesions were identified in 56 cases (71.8%), stage T4a lesions were identified in 16 cases (20.5%), and stage T4b lesions were identified in 6 cases (7.7%). Tumor size was less than 4 cm in 4 cases (59.0%) and greater than 4 cm in 32 (41.0%). Hydronephrosis was present in 21 cases (26.9%). In the 5-year survival analysis, prognostic factors significantly influencing survival rate were T-stage of the tumor and absence of hydronephrosis and complete regression after treatment (p＜0.05). Multivariate analysis revealed that tumor stage and the absence of hydronephrosis were statistically significant prognostic indicators. Conclusions: In patients with T3b, T4a, and T4b transitional carcinoma of the bladder, bladder preservation may prevent a decrease in quality of life. Also, our findings suggest that this approach could be considered a primary treatment option for patients with T3b stage tumors without evidence of hydronephrosis.