Cancer - Bladder, Pelvis, Ureter & Others(구연) (E-062) Bladder preservation with transurethral tumor resection alone in superficial muscle-invasive bladder cancer: a 10-year follow-up analysis 연세대학교 의과대학 비뇨의학과¹ 연세대학교 의과대학 비뇨의학과, 강남세브란스병원² 연세대학교 의과대학 병리과³ 허지은¹, 조강수², 이종수¹, 장원식¹, 조남훈³, 최영득¹ Purpose: Among patients with muscle-invasive bladder cancer (MIBC), bladder preservation can be applied to limited candidates. Transurethral resection of bladder tumor (TURBT) alone may be curative in superficial MIBC (T2a). We evaluated the 10-year oncological outcomes of bladder preservation with TURBT alone in selected patients with stage T2a MIBC. Materials and Methods: Between 2001 and 2009, 145 patients diagnosed with stage T2a MIBC by TURBT. Cystectomy-free survival, recurrence-free survival (RFS), progression-free survival (PFS), and cancer-specific survival (CSS) were estimated using the Kaplan-Meier method. Cox regression analysis was used to evaluate the predictors for each survival. Results: Of 145 patients, 135 underwent bladder preservation and 10 underwent immediate radical cystectomy (RC). Among the latter, nine patients showed downstaging. During a median follow-up of 132 (interquartile range 96–161) months, 13 patients underwent RC with a 10-year cystectomy-free survival rate of 83.9%. Seventy (48.3%) patients had recurrence and the 10-year RFS rate was 48.9%. Progression occurred in 12 (8.3%) patients with a 10-year PFS rate was 90.1%. Although death occurred only in patients who progressed, 5 (3.4%) patients died of bladder cancer and the 10-year CSS rate was 96.5%. Tumors greater than 3 cm were associated with RC, and a high tumor grade predicted recurrence. RC was related with progression and cancer-specific mortality. Conclusion: Although high-grade tumors require more careful follow-up, bladder preservation with TURBT alone can provide successful management of selected patients with stage T2a MIBC less than 3 cm, without carcinoma in situ or tumor-associated hydronephrosis, in a non-metastatic setting. keywords : Bladder cancer, Bladder preservation, Transurethral resection