Treatment of muscle invasive bladder tumor comparison between chemotherapy and cystectomy

Bladder Tumor is the second most common cancer of the genitor-urinary tract. Male to Female ratio: has been demonstrated as 3.5:1. To compare the efficacy of combined chemotherapy/or radical cystectomy with or without urinary diversion. The present study was conducted on 26 consecutive patients of either age and sex having histologically proven muscle invasive transitional cell carcinoma of the bladder .These patients were selected from different hospitals in Lahore including Lahore General Hospital, Mayo Hospital, Shaikh Zaid Hospital, and Services Hospital from 1994-1996. These patients were thoroughly investigated. At the initial diagnosis 18-30% of patients of bladder tumors are muscle invasive and 70% superficial. Although radical cystectomy is the treatment of choice for invasive bladder tumor, bladder-sparing technique are more often being used e.g. TURGB and Intra-vesicle chemo/immunotherapy in superficial bladder cancer, TURGB and Systemic chemotherapy in muscle invasive tumor. The use of combination Chemotherapy in advance disease is routine e.g. CMV and MVAC. In our present study a total of 26 consecutive patients of either age or sex having histologically proven muscle invasive tumor of bladder were included. These patients were collected from different hospitals at Lahore, from 1994 to 1996. Out of these 26 patients, 13 patients were included in group-A, [they were given MVAC chemotherapy] and the remaining 13 patients were included in group B, [in these patients cystectomy and urinary diversion were done]. It is concluded that the result using combined Chemotherapy MVAC are better [20%] as compared to total cystectomy/urinary diversion [12.23%] after one year follow up

Efficacy and safety of intra-vesical B.C.G in superficial bladder tumor after TURGB

To determine the effectiveness, safety and side effects of intra-vesicle B.C.G immuno-therapy in superficial bladder tumor after TURGB. Observational study / Quasi-experimental. Bolan Medical College Teaching Hospital Quetta, from August, 2004 to July, 2008. Patients age ranges from 40 to 75 years.21 males and 4 females, with proven superficial bladder tumor [Ta-Tl]were included after TURGB in this study. These 25 patients underwent intra-vesicle immunotherapy [BCG.].These patients were followed up for two years and extent of improvement in presenting symptoms, recurrence of tumor, side effects and complications were noted. Out of 25 patients 23 patients [92%] received BCG immunotherapy after TURGB. Out of these 23 Patients 15 patient [65.2%] showed complete response and 6 patients [26.08%] showed partial response while remaining 2 patients [8.69%] had constant progression in disease and underwent cystectomy. It was concluded that B.C.G immunotherapy is very effective and save patients from recurrence and cystectomy