Post-chemotherapy surgery in patients with unresectable or regionally metastatic bladder cancer Journal Article
| Authors: | Herr, H. W.; Donat, S. M.; Bajorin, D. F. |
| Article Title: | Post-chemotherapy surgery in patients with unresectable or regionally metastatic bladder cancer |
| Abstract: | Purpose: We update our experience with post-chemotherapy surgery in patients with unresectable or lymph node positive bladder cancer. Methods: Of 207 patients with unresectable or regionally metastatic bladder cancer 80 (39%) underwent post-chemotherapy surgery after treatment with a cisplatin based chemotherapy regimen. We assessed the impact of surgery on achieving a complete response to chemotherapy and on relapse-free survival. Results: No viable cancer was present at post-chemotherapy surgery in 24 of the 80 cases (30%), pathologically confirming a complete response to chemotherapy. Of the 24 patients 14 (58%) survived 9 months to 5 years. Residual viable cancer was completely resected in 49 patients (61%), resulting in a complete response to chemotherapy plus surgery, and 20 (41%) survived. Post-chemotherapy surgery did not benefit those who failed to achieve a major complete or partial response to chemotherapy. Only 1 of the 12 patients (8%) who refused surgery remains alive. Conclusions: Post-chemotherapy surgical resection of residual cancer may result in disease-free survival in some patients who would otherwise die of disease. Optimal candidates include those in whom the pre-chemotherapy sites of disease are restricted to the bladder and pelvis or regional lymph nodes, and who have a major response to chemotherapy. |
| Keywords: | cancer chemotherapy; cancer survival; cancer surgery; major clinical study; cisplatin; combined modality therapy; treatment indication; metastasis; antineoplastic combined chemotherapy protocols; bladder cancer; urinary bladder neoplasms; neoplasm metastasis; drug therapy; carcinoma, transitional cell; bladder carcinoma; bladder; humans; human; male; female; priority journal; article |
| Journal Title: | Journal of Urology |
| Volume: | 165 |
| Issue: | 3 |
| ISSN: | 0022-5347 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2001-03-01 |
| Start Page: | 811 |
| End Page: | 814 |
| Language: | English |
| PUBMED: | 11176475 |
| PROVIDER: | scopus |
| DOI: | 10.1016/S0022-5347(05)66533-0 |
| DOI/URL: | |
| Notes: | Export Date: 21 May 2015 -- Source: Scopus |
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