Potential Impact of Postoperative Early Complications on the Timing of Adjuvant Chemotherapy in Patients Undergoing Radical Cystectomy: A High-Volume Tertiary Cancer Center Experience

Donat, S. Machele; Shabsigh, Ahmad; Savage, Caroline; Cronin, Angel M.; Bochner, Bernard H.; Dalbagni, Guido; Herr, Harry W.; Milowsky, Matthew I.

doi:10.1016/j.eururo.2008.07.018

Cited by 232 publications

(118 citation statements)

References 25 publications

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“…It should be noted that less than a third of patients who were upstaged received AC -this is in line with data indicating that NC is more often successfully administered than AC (87%-97% vs. 50%-77%), 4,29 perhaps because of postoperative complications, poor performance status and renal insufficiency. 18,22,29,30 As those receiving AC had better disease-specific survival than those who did not, the inability to administer chemotherapy adjuvantly is a significant concern. 28 Adoption of new treatment paradigms can be challenging.…”

Section: Discussionmentioning

confidence: 99%

Treatment of muscle-invasive bladder cancer in Canada: A survey of genitourinary medical oncologists and urologists

Hsu

Black

et al. 2014

CUAJ

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Introduction: Uptake of neoadjuvant chemotherapy (NC) for muscle invasive bladder cancer (MIBC) has been low despite evidence of a survival benefit. The primary aim of this study was to better understand why the rates are low and determine what factors specifically influence the decision to recommend NC for MIBC. Methods: A 31-question survey was emailed between 2009 and 2011 to medical oncologists belonging to the Canadian Association of Genitourinary Medical Oncologists (CAGMO); and to urologists belonging to the Canadian Urologic Oncology Group (CUOG). We gathered data on practice characteristics, referrals for NC, factors influencing NC use, and chemotherapy regimens offered. Responses were summarized using descriptive statistics. Results: In total, 26/30 (87%) medical oncologists and 25/84 (30%) urologists, who were primarily academic, completed the survey. Most clinicians (medical oncologists 96%, urologists 88%) recommended NC for MIBC, because they considered it to be the standard of care, but most medical oncologists saw ≤6 referrals annually. Performance status, presence of comorbidities and renal function were key considerations in offering NC. NC was not offered if performance status ≥2 (medical oncologists 38%, urologists 44%), age >80 (medical oncologists 46%, urologists 39%), or glomerular filtration rate ≤40 mL/min (medical oncologists 81%, urologists 50%). Conclusions: Most academic clinicians in Canada believe that cisplatin-based combination NC is the standard of care for MIBC and recommend it for patients with adequate performance status and renal function. Using a multidisciplinary approach to treat this disease may be one strategy to increase referral rates for NC and uptake of NC.

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Section: Discussionmentioning

confidence: 99%

Treatment of muscle-invasive bladder cancer in Canada: A survey of genitourinary medical oncologists and urologists

Hsu

Black

et al. 2014

CUAJ

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“…52,195 Donat et al showed that about 30% of patients undergoing a radical cystectomy might have a surgical complication that could preclude or delay their ability to receive adjuvant chemotherapy, supporting the use of perioperative chemotherapy in the neoadjuvant setting. 196 The disadvantage of both neoadjuvant and adjuvant chemotherapy is the toxicity associated with the different regimens. MVAC has been shown to have significant toxicities including severe granulocytopenia, nausea and vomiting, stomatitis, and diarrhea or constipation.…”

Section: Urinary Diversionmentioning

confidence: 99%

Bladder Cancer in 2010: How Far have We Come?

Jacobs¹,

Lee

Montie

2010

CA: A Cancer Journal for Clinicians

295

275

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Bladder cancer is the fourth most common cancer and ranks eighth as a cause of death from cancer among men in the United States. Although guidelines assist in treatment, the art of managing bladder cancer, such as the decision to use neoadjuvant chemotherapy and the timing of cystectomy, is still variable. Bladder cancer has a propensity to recur, and with recurrence, a significant number of cases progress, which makes the early detection of high-risk patients imperative. Advances in detection, surveillance, and treatment of bladder cancer are reviewed in this article.

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“…Güncel çalış-malardan elde dilen verilerde operasyon sırasında morbiditenin oldukça yüksek olduğu ve hastaların %64'ünde komplikasyon geliştiği görülmektedir (18).…”

Section: Neoadjuvan Ve Adjuvan Kemoterapiunclassified

Radical Cystectomy and Organ Preservation Treatment Modalities in Muscle-invasive Bladder Cancer

Kadıhasanoğlu¹,

Aydın²,

Karabay³

et al. 2016

Istanbul Med J

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GirişBatı dünyasında erkeklerde en sık görülen kanserler arasında prostat, akciğer ve kolon kanserinden sonra dördüncü sırada mesane kanseri yer almaktadır (1). Tüm dünya için ciddi bir sağlık problemi oluşturan mesane kanserinde hastaların büyük çoğunluğuna yüzeysel evredeyken tanı konulmakla beraber %20−40 kadarı kasa invaze ya da o evreye ilerlemek üzere tespit edilmektedir ve her yıl 100.000'den fazla olguya kasa invaze ya da ileri evre hastalık tanısı konmaktadır (1). Daha çok erkeklerde görülen mesane kanserinin insidansı kadınlarda da gittikçe artmaktadır.Makroskopik hematüri, işeme bozuklukları ve pelvik ağrı gibi belirtilerle ortaya çıkan mesane kanserinde tanı, transüretral yoldan kas tabakasını da içerecek şekilde yapılan rezeksiyondan elde edilen doku örneklerinin patolojik değerlendirmesi sonucu konulur. Tedavideki amaç, hastaya tümörsüz ve konforlu bir yaşam sağlamaktır. Bu amaçla günümüzde çift taraflı pelvik lenfadenektomi ile beraber uygulanan radikal sistektomi (RS) altın standart tedavi yöntemi olarak kabul edilse de seçilmiş hastalara mesane koruyucu yaklaşımlar birçok merkezde uygulanmaktadır.Bu derlemede amaç, güncel literatür eşliğinde mesane kanseri tedavisinde uygulanan yöntem-leri gözden geçirerek radikal cerrahi yöntemle mesane koruyucu girişimlerin değerlendirmesini yapmaktır. Radikal Sistektomi GirişRadikal sistektomi ve çift taraflı pelvik lenfadenektomi, günümüzde kasa invaze mesane kanserlerinin tedavisinde altın standart olarak kabul edilmektedir. RS geleneksel olarak lokalize (cT2N0M0) ve lokal ileri evre (cT3a-T4a, N0-NX, M0) mesane kanserinde önerilen tedavi seçeneğidir (2). Bunun dışında yüksek riskli ve tekrarlayan yüzeyel tümörlerde, BCG'ye dirençli karsinoma insituda (cis), yük-sek dereceli T1 tümörlerde ve transüretral rezeksiyon ve intravezikal tedaviyle kontrol edilemeyecek yaygın papiller tümörlerde de RS endikasyonu bulunmaktadır (3). Uzun dönem hastalıksız sağ kalım oranı %70'in üzerinde bildirilmekte olan RS, en başarılı sağ kalım ve an az lokal rekürrens oranlarına da sahip olup tümörün tam olarak ortadan kaldırılmasını sağlar. Organ korucu yöntemlerin tümörü tamamen temizleyememeleri ve zaman kaybına neden olmaları dolayısıyla RS'nin başarısını düşürdüğü bilinmektedir. Tanı konulduktan sonra radikal operasyon için 90 günden fazla bekletilen hastalarda ekstravezikal hastalık riski %2'den %81'e çıkmaktadır (4). Kasa İnvaze Mesane Tümörlerinde Radikal Sistektomi ve Organ Koruyucu Tedavi Seçenekleri Radical Cystectomy and Organ Preservation Treatment Modalities in Muscleinvasive Bladder CancerWorldwide, bladder carcinoma is the most diagnosed cancer, and it is the most common urologic malignancy among men in Turkey. Although bladder carcinoma is diagnosed at an early stage of the disease, 100,000 patients are diagnosed with the muscle-invasive or advanced stage each year. Radical cystectomy (RC) and bilateral lymph node dissection are the gold standard treatments for muscle-invasive bladder cancer. Partial cystectomy, chemotherapy, radiotherapy, transurethral resectio...

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Potential Impact of Postoperative Early Complications on the Timing of Adjuvant Chemotherapy in Patients Undergoing Radical Cystectomy: A High-Volume Tertiary Cancer Center Experience

Cited by 232 publications

References 25 publications

Treatment of muscle-invasive bladder cancer in Canada: A survey of genitourinary medical oncologists and urologists

Treatment of muscle-invasive bladder cancer in Canada: A survey of genitourinary medical oncologists and urologists

Bladder Cancer in 2010: How Far have We Come?

Radical Cystectomy and Organ Preservation Treatment Modalities in Muscle-invasive Bladder Cancer

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