Neoadjuvant chemotherapy and partial cystectomy for invasive bladder cancer.
J Clin Oncol
; 12(5): 975-80, 1994 May.
Article
em En
| MEDLINE
| ID: mdl-8164050
ABSTRACT
PURPOSE:
This clinical trial evaluated a bladder-sparing strategy using a combined modality approach of neoadjuvant methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) chemotherapy followed by a partial cystectomy for patients with invasive (T2-4N0M0) bladder cancer. PATIENTS ANDMETHODS:
One hundred eleven surgical candidates received a median of four cycles of neoadjuvant M-VAC. Following treatment, of those with a favorable response to chemotherapy based on cystoscopic examination, 26 underwent a partial cystectomy.RESULTS:
Of 26 patients, 17 (65%) are alive beyond 5 years (median, 6.9 years; range, 4 to 8), including 14 (54%) with an intact, functioning bladder. Twelve patients (46%) developed bladder recurrences, which were invasive in five (18%) and superficial in seven (26%). Patients with no (P0) or noninvasive (Pis) tumor in their surgical specimens had a 5-year survival rate of 87% (14 of 16), compared with 30% (three of 10) among patients with residual invasive cancer. The majority of deaths was attributed to preexisting metastases.CONCLUSION:
Neoadjuvant M-VAC chemotherapy permitted bladder-sparing surgery in selected responding patients with invasive bladder neoplasms. The bladder remained at risk for new tumor development, but local recurrences were treated successfully by local therapy or salvage cystectomy.
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Bexiga Urinária
/
Carcinoma
/
Protocolos de Quimioterapia Combinada Antineoplásica
Limite:
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
1994
Tipo de documento:
Article