Sequential transurethral surgery, multiple drug chemotherapy and radiation therapy for invasive bladder carcinoma: Initial report

Červek, Jožica; Čufer, Tanja; Kragelj, Borut; Zakotnik, Branko; Stanonik, M

doi:10.1016/0360-3016(93)90305-f

Cited by 22 publications

(3 citation statements)

References 10 publications

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“…As it can be observed from the Table; that the response rates at the end of therapy and the survival rate, are in line with the previous studies. [11][12][13][14] Radical cystectomy has been the standard of care for treatment of Carcinoma of Urinary Bladder but it is not the kind of treatment that a patient would opt for if given a choice of bladder preservation approach with equivalent 5 year overall surviva. l2, 15,16 If patient is offered bladder preservation protocol, he has the choice of salvage cystectomy which can be carried after confirmation of incomplete response or recurrent disease.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Patients Treated With Bladder Preservation Protocol in Urothelial Carcinoma of Urinary Bladder

Hussain

Syed

Samad³

2021

PAFMJ

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Objective: To explore trimodality treatment with neoadjuvant chemotherapy followed by concurrent chemoradiotherapy as an alternative approach to neoadjuvant chemotherapy followed by radical cystectomy, for the treatment of non-metastatic muscle invasive bladder carcinoma. Study Design: Retrospective observational study. Place and Duration of Study: Combined Military Hospital Rawalpindi Pakistan, from 2006 and 2015. Methodology: A total of 122 patients were evaluated in a retrospective manner. Primary endpoint was overall survival. Patients received four courses of neoadjuvant chemotherapy followed by radical concurrent chemoradiotherapy with Cisplatin as radiation sensitizer. Result: 5-year overall survival was 80 (66%) in this population and a complete response following completion of treatment was seen in 93 (76.3%) patients. Subset analysis showed markedly increased 5-year overall survival of around 104 (85%) in patients having complete response after neoadjuvant chemotherapy. Conclusion: The study concludes that bladder preservation is an acceptable alternative to radical cystectomy in selected population especially among those who had a complete response to the initial four courses of chemotherapy.

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Section: Discussionmentioning

confidence: 99%

Outcome of Patients Treated With Bladder Preservation Protocol in Urothelial Carcinoma of Urinary Bladder

Hussain

Syed

Samad³

2021

PAFMJ

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“…On the other hand, cystectomy with some form of urinary diversion reduces the quality of life considerably. Much data now exists to support the use of transurethral surgery and the combination of chemoradiotherapy as one treatment option for patients with muscle‐invading tumors [6–10, 15–17].…”

Section: Discussionmentioning

confidence: 99%

“…Despite great advances in surgical techniques, radical cystectomy is curative in no more than 50% of patients as a consequence of occult widespread tumor metastases [3–5]. Because of disappointing results in terms of survival and decreased quality of life associated with the surgery, in the past decade several clinical studies were conducted using a bladder‐sparing approach in an attempt to improve overall survival while maintaining a functional bladder [6–10].…”

Section: Introductionmentioning

confidence: 99%

Invasive bladder cancer:A single-institution experience with bladder-sparing approach

et al. 2000

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Our objective was to assess the efficacy and safety of a selective bladder‐preserving approach by transurethral resection and sequential chemoradiotherapy in patients with muscle‐invasive bladder cancer. From 1989 through 1997, 40 patients with biopsy‐confirmed bladder cancer, clinical stages T2–4NxM0, were treated with induction by aggressive transurethral resection (TUR) and three cycles of methotrexate, cisplatin, and vinblastine (MCV) chemotherapy. Tumor response was evaluated by cystoscopy and biopsy. In complete responders, the treatment was continued by radiotherapy (60 Gy to the bladder and 50 Gy to pelvic lymph nodes). Radical cystectomy was recommended to patients with residual tumor. Clinical complete response rate to TUR and MCV chemotherapy was 70%. The 4‐year actuarial overall survival rate for the whole series was 80.5%. Among 36 patients who completed chemotherapy and radiotherapy, the 4‐year actuarial survival was 84%, with 82.6% surviving with their bladders intact. Freedom from local failure in complete responders to TUR‐chemotherapy was 84%. Multivariate analysis revealed that the extent of initial TUR and status after TUR‐chemotherapy were independent prognostic factors associated with survival and disease‐free survival. This study confirms that the combination of aggressive TUR and sequential chemoradiotherapy with bladder preservation is an alternative treatment option to primary cystectomy for selected patients with invasive bladder carcinoma. Int. J. Cancer (Radiat. Oncol. Invest.) 90, 287–294 (2000). © 2000 Wiley‐Liss, Inc.

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Bladder preservation in muscle‐invasive bladder cancer by conservative surgery and radiochemotherapy

Dunst

Rödel

Zietman

et al. 2001

Seminars in Surgical Oncology

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Organ preservation has been investigated in muscle-invasive bladder cancer over the past decades as an alternative to standard radical cystectomy. The results of large prospective protocols and population-based studies suggest that an organ-preserving approach is possible without deferring the survival probability. Organ preservation requires a trimodal schedule, including transurethral surgery (transurethral resection of bladder tumor (TURBT)), radiation, and chemotherapy. A complete TURBT is the most important single prognostic factor, and should be attempted. Radiotherapy, in conjunction with concurrent platinum-based chemotherapy, can control the vast majority of urothelial bladder tumors. The histologically-proven complete remission rates of macroscopic tumors (unresectable by TURBT) lie in the range of about 70%. After radiochemotherapy, a histological response evaluation with repeated TURBT is recommended. Patients with residual tumor require salvage cystectomy. In cases of complete remission, patients can maintain their bladders but they should be closely followed over years. The risk of severe late-radiation sequelae is low, in the range of less than 5%. About 75% of long-term survivors maintain a normally functioning bladder.

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Sequential transurethral surgery, multiple drug chemotherapy and radiation therapy for invasive bladder carcinoma: Initial report

Cited by 22 publications

References 10 publications

Outcome of Patients Treated With Bladder Preservation Protocol in Urothelial Carcinoma of Urinary Bladder

Outcome of Patients Treated With Bladder Preservation Protocol in Urothelial Carcinoma of Urinary Bladder

Invasive bladder cancer:A single-institution experience with bladder-sparing approach

Bladder preservation in muscle‐invasive bladder cancer by conservative surgery and radiochemotherapy

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