Outcomes of bladder preservation therapy on survival in patients with muscle-invasive bladder cancer. / Resultados de preservación vesical en pacientes con tumor vesical musculoinfiltrante.

ABSTRACT

INTRODUCTION: The standard of care in muscle invasive bladder cancer is radical cystectomy; however; transurethral resection (TUR) followed by external radiotherapy and systemic chemotherapy demonstrates comparable results with radical cystectomy in terms of local control and survival rates. OBJECTIVES: To evaluate our results of multimodality bladder preservation therapy (BPT) in patients who had muscle-invasive bladder cancer and were reluctant to radical cystectomy. METHODS: The retrospective analysis of twenty-three patients with stage T2 transitional cell bladder cancer that were consecutively treated with BPT was performed. Treatment strategy included radical TUR followed by 3 cycles of cisplatin, gemcitabine combination, and radiotherapy of 64 Gy as adjuvant treatment. The Kaplan-Meier survival estimates and log rank were calculated. RESULTS: Median follow-up time was 58 (15-158) months. Disease-free survival (DFS) and five year overall survival (OS) rates for 23 patients were 55.9% and 63.9%, respectively. Cancer-specific OS was 67%. There were no grade 3 or higher complications. CONCLUSIONS: Our small patient group suggests that BPT can be safely applied in selected cases with bladder cancer or in patients that refused radical cystectomy.

RESUMEN

INTRODUCCIÓN: El estándar de tratamiento en el CVMI es la cistectomía radical, aunque la RTUv + RTP+ quimioterapia sistémica demuestra resultados comparables a la cistectomía radical en términos de control local y supervivencia global. OBJETIVOS: Evaluar nuestros resultados en terapia trimodal en cáncer de vejiga músculo-invasivo que rechazan la cistectomía radical. MÉTODOS: Análisis retrospectivo de 23 pacientes con estadio T3 TVMI tratados con preservación vesical (RTUv +3 ciclos de gemcitabina, cisplatino+ 64Gy RTP adyuvante). KM estimados y log Rank fueron calculados. RESULTADOS: La mediana de seguimiento fue de 58 meses (15-158). El intervalo libre de enfermedad y la supervivencia global a los 5 anos fue de 56% y 64%, respectivamente. La Supervivencia cáncer especifica fue de 67%. No se objetivaron complicaciones grado 3 o más. CONCLUSIONES: Nuestra serie de tratamiento preservación vesical demuestra que el uso de este tratamiento en pacientes debidamente seleccionados que no quieren cistectomía radical es apropiado.