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Organ Conservation in Invasive Bladder Cancer by Transurethral Resection, Chemotherapy and Radiation: Results of a Urodynamic and Quality of Life Study on Long-term Survivors

2003; Lippincott Williams & Wilkins; Volume: 170; Issue: 5 Linguagem: Inglês

10.1097/01.ju.0000093721.23249.c3

1527-3792

Anthony L. Zietman, Dianne Sacco, URI SKOWRONSKI, Pablo Gomery, Donald S. Kaufman, Jack A. Clark, James A. Talcott, William U. Shipley,

Gastric Cancer Management and Outcomes

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Nov 2003Organ Conservation in Invasive Bladder Cancer by Transurethral Resection, Chemotherapy and Radiation: Results of a Urodynamic and Quality of Life Study on Long-term Survivors ANTHONY L. ZIETMAN, DIANNE SACCO, URI SKOWRONSKI, PABLO GOMERY, DONALD S. KAUFMAN, JACK A. CLARK, JAMES A. TALCOTT, and WILLIAM U. SHIPLEY ANTHONY L. ZIETMANANTHONY L. ZIETMAN , DIANNE SACCODIANNE SACCO , URI SKOWRONSKIURI SKOWRONSKI , PABLO GOMERYPABLO GOMERY , DONALD S. KAUFMANDONALD S. KAUFMAN , JACK A. CLARKJACK A. CLARK , JAMES A. TALCOTTJAMES A. TALCOTT , and WILLIAM U. SHIPLEYWILLIAM U. SHIPLEY View All Author Informationhttps://doi.org/10.1097/01.ju.0000093721.23249.c3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Transurethral resection, chemotherapy and radiation with salvage cystectomy may be used as alternatives to immediate radical cystectomy in the management of invasive bladder cancer. Concern exists about the function of the retained bladder after such therapy. Materials and Methods: Of 221 patients with clinical T2–4a bladder cancer treated at Massachusetts General Hospital from 1986 to 2000 with trimodality therapy, 71 were alive with native bladders and disease-free in 2001. These patients were asked to undergo a urodynamic study and to complete a quality of life questionnaire. A total of 69% participated in some component of this study with a median time from trimodality therapy of 6.3 years (range 1.6 to 14.9). Results: Of 32 patients 24 had normally functioning bladders by urodynamic study. Decreased bladder compliance was seen in 7. Bladder hypersensitivity, involuntary detrusor contractions and incontinence were present in 2 women. The questionnaire showed that flow symptoms occurred in 6%, urgency in 15% and control problems in 19%. Of all women 11% wore pads. Distress from urinary symptoms was half as common as prevalence. Bowel symptoms occurred in 22% with 14% recording any level of distress. The majority of men retained sexual function. Global health related quality of life was high. Conclusions: The majority of patients treated with trimodality therapy retain good bladder function. A fifth have evidence of bowel dysfunction. References 1 : Reanalysis and results after 12 years of follow-up in a randomized trial comparing total mastectomy with lumpectomy with or without radiation in the treatment of breast cancer. N Engl J Med1995; 333: 1456. 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Link, Google Scholar From the Departments of Radiation Oncology (ALZ, US, WUS), Urology (DS, PG) and Medical Oncology (DSK, JAT), Massachusetts General Hospital, Harvard Medical School, and Department of Health Services (JAC), Boston University School of Public Health, Boston, Massachusetts© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byEswara J, Efstathiou J, Heney N, Paly J, Kaufman D, McDougal W, McGovern F and Shipley W (2011) Complications and Long-Term Results of Salvage Cystectomy After Failed Bladder Sparing Therapy for Muscle Invasive Bladder CancerJournal of Urology, VOL. 187, NO. 2, (463-468), Online publication date: 1-Feb-2012.PARKINSON J and KONETY B (2018) HEALTH RELATED QUALITY OF LIFE ASSESSMENTS FOR PATIENTS WITH BLADDER CANCERJournal of Urology, VOL. 172, NO. 6 Part 1, (2130-2136), Online publication date: 1-Dec-2004. Volume 170Issue 5November 2003Page: 1772-1776 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordsbladder neoplasmsdrug therapyradiationquality of lifeurodynamicsMetrics Author Information ANTHONY L. ZIETMAN More articles by this author DIANNE SACCO More articles by this author URI SKOWRONSKI More articles by this author PABLO GOMERY Financial interest and/or other relationship with Eli Lilly Co. and GlaxoKlineSmith. More articles by this author DONALD S. KAUFMAN More articles by this author JACK A. CLARK More articles by this author JAMES A. TALCOTT More articles by this author WILLIAM U. SHIPLEY More articles by this author Expand All Advertisement PDF downloadLoading ...