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Long-term outcomes of combined treatment of bladder-preserving surgery and adjuvant intraarterial chemotherapy for patients with stage T2 bladder cancer / 中华泌尿外科杂志
Chinese Journal of Urology ; (12): 568-572, 2017.
Artigo em Chinês | WPRIM | ID: wpr-610935
ABSTRACT
Objective To evaluate the efficacy of patients with stage T2 bladder cancer who underwent combined treatment of bladder-preserving surgery and adjuvant intra-arterial chemotherapy.Methods The survival data of bladder cancer paients from January 2000 to December 2014 with stage T2N0M0 were retrospectively analyzed.Thirty-five patients of cT2N0M0 receive combined treatment of bladder-preserving surgery and adjuvant intra-arterial chemotherapy(group A),and 80 patients of pT2N0M0 underwent radical cystectomy (RC) (group B).The pathological diagnosis of all patients was urothelial carcinoma.In group A,there were 33(94.2%) males and 2 (5.8%) females;20 (57.1%) tumor size less than 3 cm and 15 (42.9%) larger than 3 cm;24 (68.6%) with single tumor and 11 (31.4%) with multiple tumors;11 (31.4%) patients with primary tumors and 24 (68.6%) recurrent tumors.In group B,there were 71 (88.7%) males and 9 (11.3%) females;35 (43.8%) tumor size less than 3 cm and 45(56.2%) larger than 3 cm;44 (55.0%) with single tumors and 36 (45.0%) with multiple tumors;22(27.5%) patients with primary tumors and 58 (72.5%) recurrent tumors.Results Groups A and B consisted of 35 and 80 patients and median follow-up time was 68 (13-157)and 67 (4-198)months,respectively.There was no significantly statistical difference in disease-specific survival (DSS) between the two groups(P =0.888),76.5% for group A and 60.6% for group B respectively.In group A,26 (74.3%) patients achieved complete response (CR) to intra-arterial chemotherapy.Additionally,amounts of 21 (60.0%) patients preserve their functional bladder successfully and their median follow-up time was 69 (13-134)months.8 patients receive delayed radical cystectomy when suffered tumor recurrence and none of them had lymph node metastases.Of those pathological stage was presented as stage T2 5 cases,T3 2 cases and T4 1 case.Importantly,the 8 patients who receive delayed RC did not confer worse DSS when compared with those underwent immediate RC in group B (P =0.809).Cox proportional hazards model showed that tumor number and CR to intra-arterial chemotherapy was independent prognostic factor for disease-free survival (HR =0.238,P =0.007) and DSS(HR =0.085,P =0.004) respectively.During the period of intra-arterial chemotherapy,we did not observe hematological toxicity of grade Ⅳ and the hematological toxicity of grade Ⅰ-Ⅲ was 9 (25.7%),6 (17.1%) and 4 (11.4%).Conclusions For patients with T2N0M0,combined treatment of bladder-preserving surgery and adjuvant intra-arterial chemotherapy could be a therapy with long-term survival outcome and safety.The therapy could be offered as alternative treatment option for patients who were unsuitable for receiving RC.

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Tipo de estudo: Estudo prognóstico Idioma: Chinês Revista: Chinese Journal of Urology Ano de publicação: 2017 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Tipo de estudo: Estudo prognóstico Idioma: Chinês Revista: Chinese Journal of Urology Ano de publicação: 2017 Tipo de documento: Artigo