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 TCCsurvival 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 muscleinvasivebladder 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 meansurvival time of 32.6 months. For NMIBC, the 5-year OS was 53.8% with a mean survival of 54.5 months. ForMIBC, the 5-year OS was 19% with a mean survival of 25.4 months. Regarding pathological stage, the 5-yearOS for stage 0, I, II, III, and IV was 83.3%, 45%, 30%, 18.8%, and 9.1%, respectively.
Conclusion: The overallsurvival of bladder TCC in Indonesia is low compared to other countries. Possible explanations include thehigh number of advanced-stage tumours at initial presentation, under-staging, significant number of treatmentrefusal by our patients, and the non-standardized use of adjuvant therapy in our centre.