Primary cT2 Bladder Cancer: A Good Candidate for Radiotherapy Combined with Cisplatin for Bladder Preservation

Hara, Takahiko; Nishijima, Jun; Miyachika, Yoshihiro; Yamamoto, Yoshiaki; Sakano, Shigeru; Matsuyama, Hideyasu

doi:10.1093/jjco/hyr064

Cited by 11 publications

(3 citation statements)

References 10 publications

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“…The correct assessment of bladder cancer extent – both mucosal spread plus three‐dimensional tumor load – rather than relying on the conventional T‐stage system is the bottom line. For the bladder preservation technique, clinical T stage, but not the pathological T stage, are used as the disease stage . The drawbacks of the current T‐staging system has to be discussed for the preservation therapy.…”

Section: Principles Of Bladder Preservationmentioning

confidence: 99%

“…For the bladder preservation technique, clinical T stage, but not the pathological T stage, are used as the disease stage. [5][6][7] The drawbacks of the current T-staging system has to be discussed for the preservation therapy. Koga et al propose that patients proven to be non-CR after induction CRT in bladder-sparing approaches be grouped into different risk groups for death based on conventional pathology of cystectomy specimens.…”

Section: Tumor Assessmentmentioning

confidence: 99%

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Can bladder preservation therapy come to the center stage?

et al. 2017

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Decision-making in urological cancer care requires a multidisciplinary approach for refinement, but its impact on urothelial carcinoma of the bladder has not been fully addressed for the past three decades, except for the latest immunological checkpoint inhibitor approved by the U.S. Food and Drug Administration for metastatic muscle-invasive bladder cancer that is resistant to platinum-based chemotherapy. For the time being, radical cystectomy is the gold standard of curative therapy for muscleinvasive bladder cancer. Trimodal therapy that combines chemotherapy for the purpose of radiation sensitization, external beam radiotherapy and transurethral resection of bladder tumor has emerged as a potential alternative treatment option that preserves the bladder. In lack of randomized studies for bladder preservation therapy compared with surgery, the principles of management of urothelial carcinoma of the bladder have evolved in recent times, with an emphasis on bladder preservation. A number of bladder preservation techniques are available to the surgeon; however, appropriately selected patients with muscle-invasive bladder cancer should be offered the opportunity to discuss various treatment options, including organ-sparing trimodal therapy. The aim of the present study was to compare the primary outcomes of the available treatment methods and identify the sources of variance among studies. A review of various bladder preservation techniques in vogue for the management of urothelial carcinoma of the bladder is discussed.

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Section: Principles Of Bladder Preservationmentioning

confidence: 99%

Section: Tumor Assessmentmentioning

confidence: 99%

Can bladder preservation therapy come to the center stage?

et al. 2017

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“…However, a recent review of the CRT for MIBC reported that the mean 5-year overall survival (OS) after treatment was 57%, which was comparable to or better than that after radical cystectomy [3]. We also reported a bladder-preservation strategy comprising a CRT with cisplatin (CDDP-radiation [CDDP-R]) as an alternative to ORC with a 77.7% OS and a 64.5% 5-year progression-free survival (PFS) after treatment for primary clinical T2 tumors [4].…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Trimodal Chemoradiotherapy with Cisplatin as a Bladder-Preserving Strategy for the Treatment of Muscle-Invasive Bladder Cancer

Nagao

Hara²,

Nishijima³

et al. 2017

Urol Int

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Introduction: Open radical cystectomy (ORC) is currently the standard treatment for muscle-invasive bladder cancer (MIBC) without metastasis, while many patients with MIBC are not always appropriate candidates due to multiple comorbidities. To evaluate the bladder-preservation strategy, we compared the results with those obtained by ORC. Patients and Methods: We retrospectively analyzed the data of 50 patients with MIBC treated by trimodal chemoradiotherapy with cisplatin (CDDP-radiation [CDDP-R]). Transurethral resection of the bladder tumor (TURBT) was performed before treatment to confirm pathological stage ≥T2. Extensive TURBT was performed after chemoradiotherapy to evaluate the pathological response to treatment. We compared the survival outcomes of our CDDP-R with those of ORC (retrospective cohort, n = 205) by propensity score matching analysis. Results: The 2- and 5-year progression-free survival, bladder-intact survival, cancer-specific survival, and overall survival (OS) rates after treatment were 70.8 and 63.9%, 64.0 and 49.8%, 86.7 and 71.8%, and 84.3 and 64.8%, respectively. The 2- and 5-year OS rates after CDDP-R were 90.5 and 74.3%, respectively, and those after ORC were 71.8 and 59.9%, respectively, indicating a significant survival advantage conferred by CDDP-R over ORC (p < 0.05, HR 0.45, 95% CI 0.21-0.94). Conclusions: In selected patients, CDDP-R for MIBC may provide comparative oncological outcomes as ORC.

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