Survival of patients with transitional cell carcinoma of the urinary bladder in indonesia: a single institution review.

OBJECTIVE To describe for the first time the survival of bladder transitional cell carcinoma (TCC) in Indonesia, according to clinicopathological characteristics. MATERIALS AND METHODS Retrospective study of bladder TCC survival in a single institution, Cipto Mangunkusumo Hospital, Indonesia's national tertiary referral centre, between the years 1995 and 2005. The Kaplan-Meier method was used to determine the overall survival (OS). RESULTS The evaluable data covered 254 cases of primary bladder TCC, in which 95 (37.4%) were non muscle-invasive bladder cancer (NMIBC), and 159 cases (62.6%) were muscle-invasive (MIBC). Of these, 105 cases (41.4%) with a follow-up period up to five years were eligible for survival analysis. The mean age was 56.5 +/- 12.1 years old, with a male to female ratio of 6:1. The 5-year OS for all bladder TCC was 27.6%, with a mean survival time of 32.6 months. For NMIBC, the 5-year OS was 53.8% with a mean survival of 54.5 months. For MIBC, the 5-year OS was 19% with a mean survival of 25.4 months. Regarding pathological stage, the 5-year OS for stage 0, I, II, III, and IV was 83.3%, 45%, 30%, 18.8%, and 9.1%, respectively. CONCLUSION The overall survival of bladder TCC in Indonesia is low compared to other countries. Possible explanations include the high number of advanced-stage tumours at initial presentation, under-staging, significant number of treatment refusal by our patients, and the non-standardized use of adjuvant therapy in our centre.