Neo‐adjuvant chemotherapy for invasive bladder cancer. Experience with the M‐VAC regimen Journal Article
| Authors: | Scher, H.; Herr, H.; Sternberg, C.; Fair, W.; Bosl, G.; Morse, M.; Sogani, P.; Watson, R.; Dershaw, D.; Reuter, V.; Curley, T.; Vaughan, E. D. Jr; Whitmore, W.; Yagoda, A. |
| Article Title: | Neo‐adjuvant chemotherapy for invasive bladder cancer. Experience with the M‐VAC regimen |
| Abstract: | Summary— A series of 71 patients with muscle invasive bladder cancer received a median of 3 cycles (range 1–6) of methotrexate, vinblastine, Adriamycin and cisplatin (M‐VAC). Efficacy assessed by transurethral resection alone showed that 48% of patients were TO, 13% Tis and 54% had normalisation of initially positive urinary cytology after treatment. However, when considering transurethral resection of the bladder (TURB), cytology and non‐invasive procedures (CT scan and/or ultrasound), only 21% had a clinical complete remission (cCR); 48 patients (68%) had pathological evaluation and 13 (27%) were PO after treatment. Non‐responding patients had a poor prognosis: 14/30 (47%) developed metastatic disease and 13 died. In assessing the primary lesions, clinical understaging was significant. Of 15 patients who were TO cystoscopically prior to surgery, 6 (40%) had residual disease in the pathological specimen, including 4 with muscle infiltration; 23 patients (32%) remained clinically staged, only 8 of whom remain disease‐free. With a median follow‐up of 24 months (range 2–42+), 41 patients are alive and disease‐free, including 20 with a functional bladder. The large staging error raises questions concerning studies using clinical rather than pathological endpoints as the sole criteria of efficacy. Copyright © 1989, Wiley Blackwell. All rights reserved |
| Keywords: | adult; aged; major clinical study; cisplatin; doxorubicin; advanced cancer; combined modality therapy; methotrexate; cancer staging; neoplasm staging; cytology; antineoplastic combined chemotherapy protocols; vinblastine; neoplasm invasiveness; bladder neoplasms; transurethral resection; carcinoma, transitional cell; bladder carcinoma; middle age; prognosis; human; male; female; priority journal; support, non-u.s. gov't; support, u.s. gov't, p.h.s. |
| Journal Title: | British Journal of Urology |
| Volume: | 64 |
| Issue: | 3 |
| ISSN: | 0007-1331 |
| Publisher: | Wiley Blackwell |
| Date Published: | 1989-09-01 |
| Start Page: | 250 |
| End Page: | 256 |
| Language: | English |
| DOI: | 10.1111/j.1464-410X.1989.tb06008.x |
| PUBMED: | 2804561 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 14 April 2020 -- Source: Scopus |
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