Early cystectomy versus conservative management in treatment of t1g3 bladder cancer

urothelial cancer of the bladder staged as pT1G3 comprises roughly 10% of all non-muscle invasive tumors. The treatment of choice for pT1G3 bladder cancer has not been defined to date.Aim of work: to compare the oncological outcomes as regard local recurrence, progression and distant metastasis in patients with T1G3 bladder cancer treated either by conservative management using TURBT followed by intravesical BCG or by early radical cystectomy.Materials and methods: Forty patients with primary T1G3 NMIBC were included in this study. Complete TURBT was done initially. After TURBT, the 40 patients were randomly divided according to the type of the management into two groups (A and B). Group A included 20 patients who had TURBT followed by BCG. Group B included 20 patients who underwent early radical cystectomy and urinary diversion. Patients were followed at 3 months intervals during the first 2 years. Differences between the 2 groups in progression-free, tumor specific and overall survival as well as overall and tumor specific survival after deferred cystectomy were calculated.Results: Recurrence, stage progression and deferred cystectomy rates in group A were 60%, 20% and 35% respectively. Mortality and morbidity in group B were 5% and 30% respectively. Kaplan-Meier analysis of progression-free survival, overall survival and tumor specific survival between group A and B showed that there were no statistically significant differences.