Radical cystectomy for transitional cell carcinoma of the bladder. Long-term survival in high risk patients.

Debilitated, sometimes old, previously radiated patients with transitional cell carcinoma of the bladder may present with many poor prognostic features including: high grade, diffuse, carcinoma; invasion of perivesical tissue; ureteral obstruction; a fixed pelvic mass, and vascular and lymphatic invasion. Improvements in anesthesia, medical management, and nutrition have allowed radical cystectomy and long-term survival in 4 such high risk patients with locally advanced transitional cell carcinoma of the bladder, including 1 patient who had excision of his urinary tract.