Neoadjuvant chemotherapy and bladder-sparing surgery for invasive bladder cancer: Ten-year outcome Journal Article
| Authors: | Herr, H. W.; Bajorin, D. F.; Scher, H. I. |
| Article Title: | Neoadjuvant chemotherapy and bladder-sparing surgery for invasive bladder cancer: Ten-year outcome |
| Abstract: | Purpose: To evaluate the IO-year outcome of patients with invasive (T2-3N0M0, staged according to the tumor, node, metastasis system) bladder cancer who responded completely to a combination of methotrexate, vinblastine, adriamycin, and cisplatin (MVAC) chemotherapy followed by bladder-sparing surgery, Patients and Methods: Of 111 surgical candidates who received neoadjuvant MVAC, 60 (54%) achieved a complete clinical response (TO) on transurethral resection (TUR) of the primary tumor site, Of these, 28 requested follow-up with TUR alone, 15 had a partial cystectomy, and 17 elected a radical cystectomy. The patients were followed up for a median of 10 years (range, 8 to 13 years). Results: Of 43 patients who had bladder-sparing surgery, 32 (74%) are alive, which includes 25 (58%) with an intact functioning bladder, Twenty-four patients (56%) developed bladder tumor recurrences from 5 to 96 months, which were invasive in 13 (30%) and superficial in 11 (26%), Thirteen patients required a salvage cystectomy, of whom 6 died, which includes 4 (9%) from a new invasive neoplasm, Of the 17 patients who had radical cystectomy, 11 (65%) are alive, Conclusion: The majority of patients with invasive bladder tumors who achieve TO status after neoadjuvant MVAC chemotherapy preserve their bladders for up to 10 years with bladder-sparing surgery, The bladder remains at risk for new invasive tumors, Cystectomy salvages the majority, but not all, of relapsing patients. (C) 1998 by American Society of Clinical Oncology. |
| Keywords: | survival; doxorubicin; methotrexate; vinblastine; 5-year follow-up; m-vac |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 16 |
| Issue: | 4 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 1998-04-01 |
| Start Page: | 1298 |
| End Page: | 1301 |
| Language: | English |
| ACCESSION: | WOS:000072875700010 |
| PROVIDER: | wos |
| PUBMED: | 9552029 |
| DOI: | 10.1200/JCO.1998.16.4.1298 |
| Notes: | Article -- Source: Wos |
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