Fluorescent cystoscopy and transurethral electroresection in diagnosis and treatment of patients with invasive cancer of the urinary bladder

: From 1996 to 2002 we examined and treated 224 patients with invasive cancer of the urinary bladder (ICUB). The examination complex included clinical, laboratory, radiation tests, endoscopic and morphological investigations of the surgical material. The patients received four types of treatment: transurethral resection (TUR) of the bladder wall (n = 102) alone; TUR+MVAC chemotherapy (n = 56); open resection of the urinary bladder only (n = 38); open resection+MVAC chemotherapy (n = 28). In diagnosis of papillary lesions sensitivity of cystoscopy (CS) was 66.6%, fluorescent CS (FCS)--95.2%. Sensitivity in diagnosis of squamous tumors was 33.3 and 91.6%, respectively. The best results were achieved in patients with pT2A tumor invasion depth, G1 differentiation of tumor cells after TUR with adjuvant polychemotherapy (PCT) recurrences in these patients arose by 41.2% less frequently than in patients after TUR only, 5-year survival in patients after TUR+PCT was 83.3%. Thus, FCS improves diagnosis of urinary bladder tumors (sensitivity of CS was 70.0% vs that of FCS--95.0%). In cancer of the urinary bladder the organ can be saved only at stage pT2G1. A method of choice is TUR of the bladder wall with adjuvant PCT.