Carcinoma of the bladder treated by segmental resection.

We herein review 45 patients with carcinoma of the bladder treated by segmental resection from 1955 to 1976. Survival rates were similar to those reported in other series and compared favorably to those found with total cystectomy. Patients with high grade (III and IV) stage A tumors experienced a 100% recurrence rate and only 40% survived more than 5 years, whereas patients with low grade (I and II) stage A tumors had a 28% recurrence rate and 86% lived 5 years or more. Therefore, it is postulated that patients with high grade lesions, even though stage A, undergo more aggressive therapy. It also was found that extensive segmental resection, even though necessitating ureteroneocystostomy, resulted in a favorable 5-year survival rate.