الفهرس 
الملخص العربي
Anatomy Of The BladderOnly 14 pages are availabe for public view
 |  | from | 194 |  |  |
| | | from | 194 | | |
Abstract
Thirty patients (21 men and 9 women) with a mean of 57.3 years (range 35-80 years) and a median Karnofsky performance status of 80 (range 70-90 %) were enrolled in this study. Patients with histopathologically proved invasive bladder cancer,(T2 – T3b, No – Mo).
As regard disease characteristics, pathological diagnosis of T2a was 7 %, T2b was 83 % and T3 was 10 %. Sixty percent of patients had positive history of Bilharziasis and 63.3 % of patients were transitional bladder carcinoma, 36.7 % were high grade and 33.3 % were located at anterior bladder wall .
After complete resection of bladder tumor, patients received combined chemo-radiotherapy 60 Gy of fractionated radiotherapy (200 cGy per setting) over 6 weeks with Cisplatin 75 mg/ m2 q. 3ws and Gemcitabine 300 mg / m2 D 1, 8 and 15 q. 3ws for 2 cycles.
At cystoscopy assessment after end of treatment 27 out of 30 patients were disease free at the time of the cystoscopic reevaluation 4-6 weeks after the end of treatment and were confirmed by the biopsies made at the site of the primary tumor.
Another 7 patients developed an infiltrating bladder relapse and they are managed surgically if fit for surgery during the 18 months follow up . Disease free survival (D.F.S.) was 76.67% . Over all survival (O.A.S. ) was 66.67%.
Three significant prognostic factors were detected for overall survival (O.A.S.) ,performance status with P.value= 0.032, tumor size with P.value=0.000 and residual of tumor with P. value=0.000 .
Two significant prognostic factors were detected for disease free survival (D.F.S.), tumor size with P.value=0.017 and residual of tumor with P.value=0.033.
There was no morbidity from anesthesia, but perforation was detected in one patient. The treatment was subjectively well tolerated, although anemia grade 3 was observed in one patient and grade 3 cystitis occurred in 5 patients and bladder capacity was reduced to less than 250 c.c. in 3 patients .