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------=_NextPart_01C8FEE3.D6980F20 Content-Location: file:///C:/2EC446F3/CystectomyPatients_files/master15.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C8FEE3.D6980F20 Content-Location: file:///C:/2EC446F3/CystectomyPatients_files/pres.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C8FEE3.D6980F20 Content-Location: file:///C:/2EC446F3/CystectomyPatients_files/slide0001.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="windows-1252" Cystectomy Patients
Cystectomy Patients<= /span>
Shandra Wilson, MD
Assist= ant Professor
Univer= sity of Colorado
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Overview
<= span class=3DBB style=3D'position:absolute;left:-3.64%;top:.22em'>Ř90% of bladder cancer is transitional cell ca
<= span class=3DBB style=3D'position:absolute;left:-4.34%;top:.22em'>Ř10% is squamous cell (esp. Egypt)
Ř1% is adenocarcinoma (arises from urachus)
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Risk Factors for Bladder CA
ŘSmoking
ŘSmoking =
ŘSmoking
ŘAniline dyes
ŘRadiation
ŘEnvironmental exposure
ŘCyclophsophamide= 3;
ŘGenetics (slow acetelators)
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Overview
Ř80% of bladder ca= ncers are superficial and can be scraped off with minimally invasive, cystoscopic procedures
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Recur= rence and Superficial Tumors
ŘSuperficial blad= der cancer has a 50% chance of recurring.  This is increased with multiple tumors, continued smoking, and high grade disease. 
Ř
ŘBCG placed in the    bladder can prevent recurrence and progression
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Bladder Cancer Staging
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ŘPatie= nts invasive bladder cancer or recurrent high-risk bladder cancer m= ust undergo cystectomy or risk quick progression        and likely        death
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Survival is proportional to stage<= /div>
<= span class=3DBB style=3D'position:absolute;left:-4.43%;top:.22em'>Ř80-85% survival for T2 disease
<= span class=3DBB style=3D'position:absolute;left:-4.43%;top:.22em'>Ř60% s= urvival for T3 disease
<= span class=3DBB style=3D'position:absolute;left:-4.12%;top:.22em'>Ř30% s= urvival for node positive disease
<= span style=3D'visibility:hidden'>Ř
ŘPatie= nts with T3 disease or greater are treated with chemotherapy before or after surgery
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Cystectomy
Ř   Removal = of bladder, prostate, lymph nodes, possibly ovaries, anterior vagina, or urethra
Lymphadenectomy
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