Primary Cisplatin, Methotrexate and Vinblastine Chemotherapy With Selective Bladder Preservation for Muscle Invasive Carcinoma of the Bladder: Long-Term Followup of a Prospective Study
2002; Lippincott Williams & Wilkins; Volume: 167; Issue: 6 Linguagem: Inglês
10.1016/s0022-5347(05)64995-6
ISSN1527-3792
AutoresFederico de la Rosa, Rocio García‐Carbonero, J. Passas, Alicia Artajona Rosino, P. Lianes, Luis Paz‐Ares,
Tópico(s)Viral-associated cancers and disorders
ResumoNo AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jun 2002Primary Cisplatin, Methotrexate and Vinblastine Chemotherapy With Selective Bladder Preservation for Muscle Invasive Carcinoma of the Bladder: Long-Term Followup of a Prospective Study F. de la ROSA, R. GARCIA-CARBONERO, J. PASSAS, A. ROSINO, P. LIANES, and L. PAZ-ARES F. de la ROSAF. de la ROSA , R. GARCIA-CARBONEROR. GARCIA-CARBONERO , J. PASSASJ. PASSAS , A. ROSINOA. ROSINO , P. LIANESP. LIANES , and L. PAZ-ARESL. PAZ-ARES View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64995-6AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluate the efficacy and bladder preservation rate of combined modality therapy consisting of deep transurethral resection of the primary bladder tumor followed by cisplatin, methotrexate and vinblastine chemotherapy in patients with muscle invasive transitional cell carcinoma of the bladder. Materials and Methods: A total of 40 consecutive patients with clinical stage T2-T4 NX M0 bladder cancer were included in the study and treated with transurethral resection followed by 3 courses of chemotherapy. Chemotherapy consisted of 100 mg./m.2 cisplatin intravenously on day 1, 30 mg./m.2 methotrexate intravenously on days 1 and 8, and 4 mg./m.2 vinblastine intravenously on days 1 and 8 administered every 21 days. Patients with disease in complete clinical remission after cycle 3 of therapy received 3 additional chemotherapy courses. Patients in whom complete clinical remission persisted after cycle 6 were closely followed with no further therapy until disease progression. Results: A complete clinical remission was achieved in 21 patients (53%) after the first 3 cycles of therapy and a partial response occurred in 10 (25%), for an overall response rate of 78% (95% confidence interval [CI] 62% to 89%). With a median followup of 78 months (range 70 to 109) the estimated 7-year progression-free and overall survival rates were 40% (95% CI 25% to 55%) and 35% (95% CI 20% to 50%), respectively. The 7-year survival rate with a functional bladder for complete clinical remission cases was 52% (95% CI 30% to 74%). Low grade, small tumor, absence of concomitant carcinoma in situ and response to therapy were all significant predictors for an increased probability of bladder preservation in univariate analysis. However, response to therapy was the only variable with independent prognostic value in the multivariate analysis (p = 0.002). Conclusions: Transurethral resection of bladder tumor followed by cisplatin, methotrexate and vinblastine chemotherapy results in long-term bladder preservation in a significant proportion of responding patients, and may be an acceptable alternative to radical surgery in select patients with muscle invasive bladder cancer. References 1 : Cancer statistics, 1999. CA Cancer J Clin1999; 49: 1. Google Scholar 2 : Cancer of the bladder. In: Cancer: Principles and Practice of Oncology. Edited by . Philadelphia: Lippincott Williams & Wilkins2001: 1396. Google Scholar 3 : Conservative management of muscle-infiltrating bladder cancer: prospective experience. 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Google Scholar From the Urology Department and Medical Oncology Department, Hospital Universitario Doce de Octubre, Madrid, Spain© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byAudenet F, Waingankar N, Ferket B, Niglio S, Marqueen K, Sfakianos J and Galsky M (2018) Effectiveness of Transurethral Resection plus Systemic Chemotherapy as Definitive Treatment for Muscle Invasive Bladder Cancer in Population Level DataJournal of Urology, VOL. 200, NO. 5, (996-1004), Online publication date: 1-Nov-2018. Volume 167Issue 6June 2002Page: 2413-2418 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordssurgerybladderbladder neoplasmschemotherapy, adjuvantMetricsAuthor Information F. de la ROSA More articles by this author R. GARCIA-CARBONERO More articles by this author J. PASSAS More articles by this author A. ROSINO More articles by this author P. LIANES More articles by this author L. 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