Infiltrating transitional carcinoma of the bladder. Is the P/T ratio a reliable index to evaluate the effectiveness of preoperative radiotherapy on tumors of the bladder?
Escudero Barrilero, A.; Platas, A.; Fernández, A.; Fernández, E.; Rodríguez Luna, J.M.; Ruiz, C.; Maganto, E.; Romero, J.
Archivos Espanoles de Urologia 42(3): 229-235
1989
ISSN/ISBN: 0004-0614 PMID: 2604432 Document Number: 334293
To determine the efficacy of preoperative radiotherapy, we used the following index: change in the clinical relative to the pathological state. We analyzed the series of our department, which was comprised of 175 patients who had undergone radical cystectomy. The P/T ratio was obtained in 138; it dropped in 26 (19%), remained unchanged in 57 (41.3%), and increased in 55 (40%). Analysis of the disease-free interval and survival by Kaplan and Meier's method showed a significantly higher difference for the patient groups with tumor Po + P less than T and P = T than for those with P greater than T, and there were no significant differences between the Po + P less than T and P = T patient groups. However, analysis of the TLE and survival curves for group P = T by comparing the three treatment regimens utilized showed no evidence that preoperative radiotherapy prolongs both parameters. The same finding was observed for the group whose P was greater than T. Evidently, prognosis is good for the group whose P dropped. However, we do not believe that it is ascribably to the beneficial effects of radiotherapy on the tumor. We believe that this is mainly due to the fact that, by definition, patients with more aggressive tumors are excluded. In our series, P3 and P4 tumors are classed under the groups whose P is "equal to" or "greater than".