Jewett HJ. Infiltrating Carcinoma of the Bladder; relation of early diagnosis to five-year suvival rate after complete extirpation. J Am Med Assoc. 1952. 148(3):187-9.
|Hugh J. Jewett, MD|
In total, 80 patients underwent extirpative surgery: 39 simple cystectomy and 41 partial cystectomy.
- For the 19 patients with tumors infiltrating less than halfway through the muscularis, 14 (74%) lived 5-14 years.
- Only 10% had extension of tumor beyond the bladder.
- 37% were highly-malignant (high-grade).
- Only 2 patients (3%) with deeply invading tumors survived 5 years.
- 85% of these patients had evidence of extension of their disease.
- 54% were highly-malignant.
Jewett astutely noted that invasive tumors were more often high-grade, but that stage (invasion) was more important in determining outcome than grade.
Interestingly, cystoscopy was part of the diagnostic algorithm for voiding symptoms but not for resection or staging of bladder tumors. Most patient in this series presented with hematuria or irritative voiding symptoms. Hematuria was the overwhelmingly present symptom, with gross hematuria present in 65 patients and microscopic hematuria in another 7 cases. Jewett attempted to correlate the temporality and severity of symptoms with stage of disease. He found that invasive tumors trended to having a longer duration of symptoms – suggesting that bladder cancer may progress from more superficial to invasive disease with time.
In conclusion, Jewett urged that:
"The reasonably good prognosis associated with superficial tumors, in contrast to the very poor prognosis afforded by deep tumors, should emphasize to the general public, the general practitioner, and the specialist the vital importance to the patient of immediate evaluation of the cause of hematuria or vesical irritability."
To read the entire manuscript: follow the link above, visit the Centennial Website or click here.
HISTORICAL CONTRIBUTIONS highlight the greatest academic manuscripts from the Brady Urological Institute over the past 100 years. As the Brady Urological Institute approaches its centennial, we will present a HISTORICAL CONTRIBUTION from each of the past 100 years. In the most recent experience, the most highly cited article from each year is selected; older manuscripts were selected based on their perceived impact on the field. We hope you enjoy!
Life is always beautiful when you have good health. For almost a year had Hpv and I was lonely and sad luckily I was directed to a very kind and Great Dr Onokun who helped me cure my Hpv and today I am free from Hpv and very healthy thank you so much Dr Onokun Email him via: Dronokunherbalcure@gmail.comReplyDelete
DR OYAGU herbal medicine is a good remedy for herpes simplex virus cure. My name is MIGNON WRIGHT , am from USA,I am here to give my testimony about DR OYAGU who helped me in my life, i want to inform the public how i was cured from (HERPES SIMPLEX VIRUS) by DR OYAGU, i visited different hospital but they gave me list of drugs like Familiar, Zovirax, and Valtrex which is very expensive to treat the symptoms and never cured me. I was browsing through the Internet searching for remedy on HERPES and i saw comment of people talking about how DR OYAGU cured them, when i contacted him he gave me hope and send a Herbal medicine to me that i took and it seriously worked for me, am a free person now without any problem, my HERPES result came out negative, I pray to God to never let me and my family forget you in our life, am now cured permanently, you can also get your self cured my friends if you really need this doctor help, you can reach him on his website ;https://oyaguspellcaster.wixsite.com/oyaguherbalhome Email: email@example.com or via whatsapp +2348101755322ReplyDelete
I was diagnosed as HEPATITIS B carrier in 2013 with fibrosis of the
liver already present. I started on antiviral medications which
reduced the viral load initially. After a couple of years the virus
became resistant. I started on HEPATITIS B Herbal treatment from
ULTIMATE LIFE CLINIC (www.ultimatelifeclinic.com) in March, 2020. Their
treatment totally reversed the virus. I did another blood test after
the 6 months long treatment and tested negative to the virus. Amazing
treatment! This treatment is a breakthrough for all HBV carriers.