Neoadjuvant combined modality program with selective organ preservation for invasive bladder cancer: results of Radiation Therapy Oncology Group phase II trial 8802.

Tester, William J.; Caplan, Richard; Heaney, John A.; Venner, Peter; Whittington, Richard; Byhardt, Roger W.; True, Lawrence D.; Shipley, William U.

doi:10.1200/jco.1996.14.1.119

Cited by 256 publications

(120 citation statements)

References 25 publications

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“…Several studies reported promising results using combined trimodality therapy in invasive bladder cancer with transurethral resection (TUR), radiation therapy and platinumbased systemic chemotherapy (1)(2)(3)(4). Those studies demonstrated 5-year survival rates of 50-65% and approximately three-quarters of the surviving patients maintained their own bladders.…”

Section: Introductionmentioning

confidence: 97%

ERCC1 and XRCC1 expression predicts survival in bladder cancer patients receiving combined trimodality therapy

Sakano

Ogawa

Yamamoto

et al. 2013

Molecular and Clinical Oncology

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Abstract. Combined trimodality therapy, including transurethral resection and platinum-based chemoradiotherapy, has shown promising results for muscle-invasive bladder cancer. However, this type of treatment may decrease survival as a result of delayed cystectomy in patients with non-responding tumors. DNA repair proteins may affect survival of bladder cancer patients receiving combined trimodality therapy, by affecting the perioperative nature of the tumor cells or by repairing DNA damaged by platinum agents and radiation. We investigated the associations of excision repair cross-complementing group 1 (ERCC1), X-ray repair cross-complementing group 1 (XRCC1) and apurinic/apyrimidinic endonuclease 1 (APE1) expression with response and survival in 157 locally advanced bladder cancer patients receiving combined trimodality therapy, in order to determine the predictive value of the expression of these proteins in patient selection for therapy. We examined ERCC1, XRCC1 and APE1 expression in tumor specimens using immunohistochemistry. Patients positive for ERCC1, positive for XRCC1 and positive for either ERCC1 or XRCC1, exhibited significantly improved disease-specific survival rates (P=0.023, 0.025 and 0.0091, respectively). In multivariate analysis, combined ERCC1 and XRCC1 expression was independently associated with disease-specific mortality [risk ratio (RR): 0.64; 95% confidence interval (CI), 0.43-0.94 and P=0.024]. Thus, combined ERCC1 and XRCC1 expression may serve as an independent prognostic marker for survival in bladder cancer patients receiving combined trimodality therapy. Prospective studies with a larger sample size are required to confirm these results.

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Section: Introductionmentioning

confidence: 97%

ERCC1 and XRCC1 expression predicts survival in bladder cancer patients receiving combined trimodality therapy

Sakano

Ogawa

Yamamoto

et al. 2013

Molecular and Clinical Oncology

View full text Add to dashboard Cite

show abstract

“…With these programs, cystectomy is reserved for patients with an incomplete response or local relapse after combined-modality treatment. Five-year survival rates in the range of 50 -65% have been published in these series, and approximately three quarters of the surviving patients maintained their own bladders (Tester et al, 1996;Kachnic et al, 1997;Dunst et al, 2001). However, combined-modality therapy may not only be potentially harmful but also diminish survival as a result of the delay in cystectomy for some patients with nonresponding bladder tumours.…”

mentioning

confidence: 94%

Single nucleotide polymorphisms in DNA repair genes might be prognostic factors in muscle-invasive bladder cancer patients treated with chemoradiotherapy

et al. 2006

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DNA repair enzymes repair DNA damaged by platinum agents and ionising radiation. Single nucleotide polymorphisms (SNPs) in DNA repair genes modulate the repair capacity and might affect response and prognosis following platinum-based chemoradiotherapy (CRT). We investigated associations between the functional SNPs in DNA repair genes and response and survival in muscle-invasive bladder cancer patients treated with CRT to determine the predictive value of the SNPs in patient selection for bladder conservation therapy. The study group comprised 78 patients who underwent CRT for transitional cell carcinoma of the bladder. Single nucleotide polymorphisms in xeroderma pigmentosum complementation groups C (Lys939Gln, A/ C), D (XPD; Lys751Gln, A/C), and G (Asp1104His, G/C), and X-ray repair cross-complementing groups 1 (XRCC1; Arg399Gln, G/ A) and 3 (Thr241Met, T/C) genes were genotyped. Combined genotypes with at least one variant allele in XPD or XRCC1 were significantly associated with improved cancer-specific survival compared with remaining groups (P ¼ 0.009). In multivariate analysis, only the combined XPD and XRCC1 genotypes were independently associated with cancer-specific survival (P ¼ 0.04). The association was stronger in stage T3/T4 patients (P ¼ 0.0008). These results suggest that combined XPD and XRCC1 genotypes might be prognostic factors in muscle-invasive bladder cancer patients treated with CRT.

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“…A major effort was undertaken to determine the role of neoadjuvant chemotherapy in studies 88-02 and, in a randomised phase III trial, in 89-03 (Tester et al, 1996;Shipley et al, 1998). The majority of patients who relapse following definitive local therapy have distant, rather than local, relapse, indicating the likelihood of microscopic metastatic disease at the time of local therapy.…”

Section: Rtog Studiesmentioning

confidence: 99%

Selective bladder preservation for muscle-invasive transitional cell carcinoma of the urinary bladder

et al. 2004

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Invasive transitional cell carcinoma (TCC) of the urinary bladder is traditionally treated with radical cystectomy. This approach results in great morbidity and lifestyle changes, and approximately half of the patients treated in this way will experience recurrent TCC despite surgery. An alternative approach using selective bladder-preservation techniques incorporates transurethral resection of bladder tumours, radiation therapy, and chemotherapy. Over the past 20 years, international experience has demonstrated that this approach is feasible, safe, and well tolerated. Furthermore, the long-term outcomes of overall survival and disease-free survival compare favourably with the outcomes from radical cystectomy. The most important predictor of response is stage, with significantly higher long-term survival in patients with T2 disease. Another important positive predictor of complete response to therapy is the ability of the urologic oncologist to remove all visible tumour through a transurethral approach prior to initiation of radiation therapy. A negative predictive factor is the presence of hydronephrosis, and age and gender do not affect disease-free survival. The majority of patients who enjoy long-term survival do so with an intact native bladder. Quality of life studies have demonstrated that the retained bladder functions well in nearly all of these patients. Selective bladder preservation will not entirely take the place of radical cystectomy, but should be offered as an important alternative to patients newly diagnosed with muscle-invasive TCC.

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Neoadjuvant combined modality program with selective organ preservation for invasive bladder cancer: results of Radiation Therapy Oncology Group phase II trial 8802.

Cited by 256 publications

References 25 publications

ERCC1 and XRCC1 expression predicts survival in bladder cancer patients receiving combined trimodality therapy

ERCC1 and XRCC1 expression predicts survival in bladder cancer patients receiving combined trimodality therapy

Single nucleotide polymorphisms in DNA repair genes might be prognostic factors in muscle-invasive bladder cancer patients treated with chemoradiotherapy

Selective bladder preservation for muscle-invasive transitional cell carcinoma of the urinary bladder

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