Selective organ preservation in muscle-invasive bladder cancer: Review of the literature

Khosravi-Shahi, Parham; Cabezón-Gutiérrez, Luis

doi:10.1016/j.suronc.2011.10.004

Cited by 15 publications

(15 citation statements)

References 23 publications

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“…When used concurrently with RT, chemotherapy can also have a sensitizing effect and further help improve local control. Concurrent chemoradiation therapy is an established approach to treat many aggressive cancers [20–23].…”

Section: Discussionmentioning

confidence: 99%

Phase I study of concurrent weekly docetaxel, high‐dose intensity‐modulated radiation therapy (IMRT) and androgen‐deprivation therapy (ADT) for high‐risk prostate cancer

Chen

Rosenman

Hoffman³

et al. 2012

BJU International

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E 7 2 1What ' s known on the subject? and What does the study add? High-risk and locally advanced prostate cancers are diffi cult to cure with the standard regimen of radiation therapy (RT) with concurrent androgen-deprivation therapy (ADT). Multiple studies have explored the addition of docetaxel chemotherapy in attempt to improve patient outcomes. Prior Phase I studies have shown that docetaxel 20 mg/m 2 is a safe dose, when given concurrently with 70 Gy of radiation. But current standard RT for prostate cancer uses higher doses, and it is unclear if concurrent chemotherapy is safe with modern RT. This is a Phase I study that explored the addition of concurrent docetaxel chemotherapy to modern RT (intensity-modulated RT to 78 Gy) plus ADT. The study showed that weekly docetaxel at 20 mg/m 2 is safe with modern RT. At a median follow-up of 2.2 years, biochemical progression-free survival was 94%. This tripletherapy regimen is safe and promising for further evaluation in prospective trials. OBJECTIVE• To evaluate in a phase I trial, the feasibility of adding concurrent weekly docetaxel chemotherapy to high-dose intensity modulated radiation therapy (IMRT) and androgen-deprivation therapy (ADT) for treatment of high-risk prostate cancer. PATIENTS AND METHODS• Patients with high-risk prostate cancer were treated with a luteinising hormonereleasing hormone agonist (starting 2 -3 months before IMRT and lasting 2 years), IMRT of 78 Gy to the prostate and seminal vesicles, and weekly docetaxel during RT.• All patients had computed tomography and bone scans to exclude metastatic disease.• A standard 3 + 3 design was used for docetaxel dose escalation. Successive patients were treated on dose levels of 10, 15, and 20 mg/m 2 of weekly docetaxel. RESULTS• In all, 18 patients participated in the study: 15 (83%) had Gleason 8 -10 disease; the other three had either clinical T3 disease and/or a prostate-specifi c antigen (PSA) level of > 20 ng/mL.• Grade 3 diarrhoea (a defi ned doselimiting toxicity, DLT) occurred in one patient in each of the fi rst two dose levels. However, when the cohorts were expanded, no further DLT was seen.• Weekly docetaxel at 20 mg/m 2 (dose level 3) was successfully given without DLT.• No patient had grade 4 or 5 toxicity.• At a median follow-up of 2.2 years, all patients achieved a PSA nadir of < 1 ng/mL, including 13 patients who had an undetectable PSA level. The 2-year biochemical progression-free survival was 94%. CONCLUSION• A dose of 20 mg/m 2 of weekly docetaxel given concurrently with high-dose IMRT and ADT appears safe for further study in patients with high-risk prostate cancer. KEYWORDS INTRODUCTIONProstate cancer is the most common malignancy in men in the USA [ 1 ] . For patients with high-risk or locally advanced disease, outcomes are poor despite aggressive treatment. For example, in the Radiation Therapy Oncology Group (RTOG) 92-02 trial, which randomised high-risk or locally advanced patients to radiation therapy (RT) plus short-term (4 months) or long-term (28 months) concurr...

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Section: Discussionmentioning

confidence: 99%

Phase I study of concurrent weekly docetaxel, high‐dose intensity‐modulated radiation therapy (IMRT) and androgen‐deprivation therapy (ADT) for high‐risk prostate cancer

Chen

Rosenman

Hoffman³

et al. 2012

BJU International

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“…At time of diagnosis, 20-25% of tumors are muscle-invasive. The gold standard treatment of muscle-invasive tumors includes radical cystectomy, extended lymph node dissection, and UD (2). Surgery for invasive bladder cancer may be conducted for curative or palliative purposes.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of Patients Who Underwent Ureterocutaneostomy

Kızılay¹,

Şimşir²,

Cüreklibatir³

et al. 2018

uob

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Objective: Ureterocutaneostomy (UCS) is a urinary diversion (UD) method which is used rarely in a carefully selected patient group. In this study, we aimed to present the data and long-term outcomes of patients who underwent UCS treatment in our clinic. Materials and Methods: A total of 36 patients who underwent UCS between January 2000 and December 2017 were included in the study. All patients had unilateral or bilateral ureteral-skin anastomosis. The demographic data, diagnoses, comorbidities, side of UCS (unilateral-bilateral), anesthesia method, operation time, and complications of the patients were recorded from the hospital registry system. The complications and survival status of the patients until the study date were evaluated. The study data were presented as mean (minimum-maximum) and number (percent). Results: Mean follow-up time was 128.5 (8-192) months. The mean American Society of Anesthesiologists score was 3.25. The patients had significant comorbidities, mainly hypertension, chronic obstructive pulmonary disease, and coronary artery disease. UCS was performed most frequently after radical cystectomy due to muscle-invasive bladder tumour (75%) and was usually bilateral (75%). The most common indications for UCS were significant comorbidities (55%). Only 3 (8.33%) patients developed ureteral-skin anastomosis, 6 (16.66%) patients developed pyelonephritis, and 9 patients died during the follow-up period. Conclusion: Although UCS is not a first-line UD method, it should still be kept in mind in the 21 st century for patients unable to tolerate segment excision from the gastrointestinal tract and postoperative complications due to comorbidities.

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“…Gold standard in the treatment of MIBC is radical cystectomy (RC), and bilateral pelvic node dissection (PLND). [3,4] It has been reported that at the time of diagnosis, 57% of the patients who had undergone RC with the diagnosis of MIBC had muscle-invasive disease, while 43% of them had superficial bladder cancer which differentiated into MIBC during follow-up period. [5] Urinary system diversion was defined by Simon in 1852 [6] , and became a standard mode of treatment after popularization of the ileal conduit procedure by Bricker in 1950.…”

Section: Introductionmentioning

confidence: 99%

Ureterocutaneostomy: for whom and when?

Kozacıoğlu¹,

Değirmenci²,

Günlüsoy³

et al. 2014

Turkish Journal of Urology

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Objective: To discuss the indications and the results of the patients treated with ureterocutaneostomy (UCN) for urinary diversion in our center. Material and methods:Between March 2008 and November 2012, 27 patients (19 males and 8 females) were treated with UCN in our clinic. Patients' ages ranged between 56-78 years. Radical cystectomy was performed on 21 of these patients. The patients underwent transureteroureterostomy and UCN or unilateral or bilateral side-by-side UCN on the abdominal wall. Double-J stents were placed inside the ureters and changed every 12 weeks. Comorbidities and American Society of Anesthesiologists (ASA) scores were noted. Results:The patients had invasive bladder cancer (n=24), multiple tumors within and outside of a diverticulum and intractable recurrent bleeding (n=1), recurrent hemorrhage (n=1), and bladder contracture (n=1). As comorbidities, hypertension (n=14), chronic obstructive pulmonary disease (n=11), diabetes mellitus (n=10), coronary artery disease (n=8), chronic renal failure (n=1), and Crohn's disease (n=1) were detected. The ASA score was 3 or greater in 14 patients. During follow-up period, 3 patients experienced pyelonephritis, and one of them had a strictured ureteral orifice.Conclusion: UCN can be used as a method of urinary diversion in selected patients.

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Selective organ preservation in muscle-invasive bladder cancer: Review of the literature

Cited by 15 publications

References 23 publications

Phase I study of concurrent weekly docetaxel, high‐dose intensity‐modulated radiation therapy (IMRT) and androgen‐deprivation therapy (ADT) for high‐risk prostate cancer

Phase I study of concurrent weekly docetaxel, high‐dose intensity‐modulated radiation therapy (IMRT) and androgen‐deprivation therapy (ADT) for high‐risk prostate cancer

Long-Term Outcomes of Patients Who Underwent Ureterocutaneostomy

Ureterocutaneostomy: for whom and when?

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