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  • Invasive bladder cancer : our experience with bladder sparing approach
    Červek, Jožica ...
    Purpose: Muscle-invasive bladder cancer (MIBC) is a disease associated with several unresolved therapeutic questions. Radical cystecomy still represent the most frequent treatment approach. The aim ... of our study to evaluate the effect and feasibility of bladder-sparing treatment by transurethal resection (TUR) and sequential chemoradiotherapy in patients with biopsy-proven invasivebladder cancer. Merthods and material: After maximal TUR, 105 patientswere treated with two to four cycles of methotrexate, cisplatinum, andvinblastine polichemotherapy. In complete responders, the treatment was continued by radiotherapy, (50 Gy to the bladder and 40 Gy to the regional lymph nodes), whereas in nonrespoders, cystectomy was performed when feasible. Results: Complete response after TUR and chemotherapy was achived in52% of patients. After a median follow-up 42 months, 52 patients of 75 patients (69%) selected for bladder presevation were without evidence of disease in the bladder. From local failure in complete responders to chemotherapy was 80% (95% confidence interval (CI), 69-91%) at 4 years. The actuarial survival of entire group was 58% (95% CI, 47-69%), whereas the survival rate with the bladder intact was 45% (95% CI, 34-56%) at 4 years. Survival was significantly better in patients who responded to chemothetapy (79%) then nonresponders (35%, p<0.0001). There was no significant difference in survival between nonresponders who underwent cystecomy and nonresponders who completed treatment with radiotherapy (approximately 30% at 3 years). Conclusion: the present study confirms that MIBC is a heterogenous disease, and that in more than half of patients who are affected, a bladder-sparing approach is safe. Our study has also demonstrated that in nonrespoders, radical cystectomy as the treatment of choise is questionable.
    Vir: International journal of radiation oncology, biology, physics. - ISSN 0360-3016 (Letn. 41, št. 2, 1998, str. 273-278)
    Vrsta gradiva - članek, sestavni del
    Leto - 1998
    Jezik - angleški
    COBISS.SI-ID - 9360857

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