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- Title
The Efficacy of Trimodal Chemoradiotherapy with Cisplatin as a Bladder-Preserving Strategy for the Treatment of Muscle-Invasive Bladder Cancer.
- Authors
Nagao, Kazuhiro; Hara, Takahiko; Nishijima, Jun; Shimizu, Kosuke; Fujii, Nakanori; Kobayashi, Keita; Kawai, Yoshihisa; Inoue, Ryo; Yamamoto, Yoshiaki; Matsumoto, Hiroaki; Matsuyama, Hideyasu
- Abstract
Introduction: Open radical cystectomy (ORC) is currently the standard treatment for muscle-invasive bladder cancer (MIBC) without metastasis, while many patients with MIBC are not always appropriate candidates due to multiple comorbidities. To evaluate the bladder-preservation strategy, we compared the results with those obtained by ORC. Patients and Methods: We retrospectively analyzed the data of 50 patients with MIBC treated by trimodal chemoradiotherapy with cisplatin (CDDP-radiation [CDDP-R]). Transurethral resection of the bladder tumor (TURBT) was performed before treatment to confirm pathological stage ≥T2. Extensive TURBT was performed after chemoradiotherapy to evaluate the pathological response to treatment. We compared the survival outcomes of our CDDP-R with those of ORC (retrospective cohort, n = 205) by propensity score matching analysis. Results: The 2- and 5-year progression-free survival, bladder-intact survival, cancer-specific survival, and overall survival (OS) rates after treatment were 70.8 and 63.9%, 64.0 and 49.8%, 86.7 and 71.8%, and 84.3 and 64.8%, respectively. The 2- and 5-year OS rates after CDDP-R were 90.5 and 74.3%, respectively, and those after ORC were 71.8 and 59.9%, respectively, indicating a significant survival advantage conferred by CDDP-R over ORC (p < 0.05, HR 0.45, 95% CI 0.21-0.94). Conclusions: In selected patients, CDDP-R for MIBC may provide comparative oncological outcomes as ORC.
- Subjects
CHEMORADIOTHERAPY; CANCER treatment; CANCER chemotherapy; CYSTECTOMY; TRANSITIONAL cell carcinoma; BLADDER cancer; CANCER patients
- Publication
Urologia Internationalis, 2017, Vol 99, Issue 4, p446
- ISSN
0042-1138
- Publication type
Article
- DOI
10.1159/000477912