目的评价肌层浸润性膀胱癌(MIBC)保留膀胱的综合治疗疗效。方法收集本院2003年1月~2010年8月MIBC病例72例,根据治疗方式,其中保留膀胱组42例,根治性膀胱切除组30例。保留膀胱组采用膀胱部分切除或经尿道膀胱肿瘤切除(TURBt),结合放化疗。通过门诊及电话等方式随访,应用Kaplan-meier法和Log-rank检验,比较两组生存情况。结果随访患者56例,随访率78%。患者随访12~92个月,平均随访43.1个月,中位随访时间为50个月。随访期间,死于膀胱癌者34例,保留膀胱组21例(50%),根治性膀胱切除组13例(43%)。术后1、2、3、4、5年生存率保留膀胱组分别为88.1%、83.3%、61.9%、57.1%、47.6%,根治性膀胱切除组分别为86.7%、80.0%、66.7%、63.6%、53.3%。两组间差异无统计学意义。结论 MIBC采取保留膀胱的综合治疗可达到与根治性膀胱切除相似的生存率。 Objective To evaluate the curative effect of MIBC preserving bladder. Methods 72 patients with MIBC were collected from January 2003 to August 2010 in our hospital. According to the treatment, 42 cases were reserved in the bladder and 30 cases were treated by radical cystectomy. Retained bladder group using partial resection of the bladder or transurethral resection of the bladder (TURBt), combined with radiotherapy and chemotherapy. Follow-up through outpatient and telephone, Kaplan-meier method and Log-rank test were used to compare the survival of the two groups. Results 56 patients were followed up, the follow-up rate was 78%. The patients were followed up for 12 to 92 months with an average follow-up of 43.1 months. The median follow-up time was 50 months. During the follow-up period, 34 patients died of bladder cancer, 21 patients (50%) retained the bladder and 13 patients (43%) had the radical cystectomy. Survival rates of 1, 2, 3, 4, 5 years after operation in bladder group were 88.1%, 83.3%, 61.9%, 57.1% and 47.6% respectively, and those in radical cystectomy group were 86.7%, 80.0% and 66.7% 63.6%, 53.3%. No significant difference between the two groups. Conclusions MIBC can achieve the same survival rate as radical cystectomy when it is used to retain the bladder.