Journal Article

Neo-adjuvant chemotherapy and bladder preservation in locally advanced transitional cell carcinoma of the bladder

C. N. Sternberg, V. Pansadoro, F. Calabrò, L. Marini, A. van Rijn, P. De Carli, D. Giannarelli, A. Platania and A. Rossetti

in Annals of Oncology

Published on behalf of European Society for Medical Oncology

Volume 10, issue 11, pages 1301-1305
Published in print November 1999 | ISSN: 0923-7534
Published online November 1999 | e-ISSN: 1569-8041 | DOI: https://dx.doi.org/10.1023/A:1008350518083
Neo-adjuvant chemotherapy and bladder preservation in locally advanced transitional cell carcinoma of the bladder

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Background: The possibility of bladder preservation as well as the utility of neo-adjuvant chemotherapy for invasive bladder cancer are controversial issues. The purpose of this study was the evaluation of neo-adjuvant M-VAC chemotherapy and bladder preservation in patients with locally advanced transitional cell carcinoma of the bladder.

Patients and methods: Eighty-seven consecutive evaluable patients with T2–T4aNxM0 TCC of the bladder were treated with three cycles of neo-adjuvant M-VAC chemotherapy. After three cycles of M-VAC, 42 patients had TURB alone, 13 patients underwent partial cystectomy, and 32 patients were to undergo radical cystectomy.

Results: Forty (51%) patients wereT0 at the TURB following M-VAC. Thirty (71%) patients who had chemotherapy and TURB alone are alive; at a median follow-up of 54+ months (8+–109+). Twenty-four (57%) have maintained an intact bladder. Of 13 responding patients with monofocal lesions who underwent partial cystectomy, 8 patients (62%) are alive with a functioning bladder, at a median follow-up of 80+ months (16–107+ months). At a follow-up of 32 months (7–121+ months), 20 (63%) patients in the radical cystectomy group are alive. In patients who had downstaging to T0 or superficial disease, median follow-up is 55 months (10–121+ months) and five-year survival is 71%. Patients who failed to respond (T2 or greater after chemotherapy), at a median follow-up of 24 months (7–103+ months), had five-year survival of only 29%.

Conclusions: Bladder sparing in selected patients on the basis of response to neo-adjuvant chemotherapy is a feasible approach which must be confirmed in prospective randomized trials.

Keywords: bladder preservation; locally advanced bladder cancer; neo-adjuvant chemotherapy

Journal Article.  0 words. 

Subjects: Medical Oncology

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