1632 LONG TERM RESULTS WITH BLADDER-SPARING APPROACH IN MIBC

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive (II)1 Apr 20131632 LONG TERM RESULTS WITH BLADDER-SPARING APPROACH IN MIBC Michele Potenzoni, Andrea Prati, Luigi Benecchi, Antonio Savino, Annamaria Pieri, Daniel Martens, Sergio Carmelo Destro Pastizzaro, Nicoletta Uliano, Rodolfo Passalacqua, Domenico Potenzoni, Brighenti Matteo, and Donini Maddalena Michele PotenzoniMichele Potenzoni Fidenza, Italy More articles by this author , Andrea PratiAndrea Prati Fidenza, Italy More articles by this author , Luigi BenecchiLuigi Benecchi Cremona, Italy More articles by this author , Antonio SavinoAntonio Savino Fidenza, Italy More articles by this author , Annamaria PieriAnnamaria Pieri Fidenza, Italy More articles by this author , Daniel MartensDaniel Martens Fidenza, Italy More articles by this author , Sergio Carmelo Destro PastizzaroSergio Carmelo Destro Pastizzaro Fidenza, Italy More articles by this author , Nicoletta UlianoNicoletta Uliano Fidenza, Italy More articles by this author , Rodolfo PassalacquaRodolfo Passalacqua Cremona, Italy More articles by this author , Domenico PotenzoniDomenico Potenzoni Fidenza, Italy More articles by this author , Brighenti MatteoBrighenti Matteo Cremona, Italy More articles by this author , and Donini MaddalenaDonini Maddalena Cremona, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.3182AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Gold standard treatment for muscle invasive bladder cancer (MIBC) is radical cystectomy. Combined-modality treatment concept has been introduced to enhance local control with the same oncological results. Previously bladder-sparing approach has been evaluated showing that can be a reasonable option treatment for selected patients enrolled in research program protocol. The main problematic aspect is the risk to delay too much a definitive treatment and expose the patient to an unacceptable risk. We evaluate the data of a prospective study of patient enrolled in a bladder sparing protocol with a 175 months follow up. METHODS Starting from February 1994 to March 2000, 75 patients with muscle invasive bladder cancer (MIBC) underwent a complete TURB, abdomen-staging CT and chemotherapy (cisplatin +5-FU) plus pelvic 40 Gy radiotherapy. Cisplatin 20 mg/m2/die for 5 days plus 5-FU 200 mg/m2/die × 5 day weekly on week 1°, 4° and 7° as radiation sensitizers was the study protocol. Re-TURB and CT has been performed in all patients and according to clinical response (complete CR, incomplete IR) patients received radical cystectomy in case of IR meanwhile patients achieving CR have been followed on regular basis. The median age of the patients was 67 years old (range 42-80 years), 9 female and 66 males. Median follow up was 94 months. In 24 case (32%) hydronephrosis was present at the time of diagnosis. 32 patients (42,6%) had a clinical T 2 tumor, 35 patients (46,7%) T3 and 8 patients (10,7%) a clinical T4 TCC. G3 grade was present in 66 cases. RESULTS CR has been achieved in 45 patients, and 50 patients (67%) preserved the bladder, 25 patients underwent to radical cystectomy 6 for salvage cystectomy and 1 patient for late toxicity. 25 patients (33%) are alive at 175 months of follow up, 33 patients (44%) died of TCC and 17 (23%) patients died of other causes not related to TCC. OS of the population is 60% at 5-years and respectively 33% at the end of the follow up. DSS is 51% at 175 months of follow up. CONCLUSIONS Long time results show that preserving the bladder in a bladder-sparing approach is feasible in patients achieving CR and further randomized study should be performed to compare ultimately radical cystectomy to bladder sparing and to understand which patients could take advantage of this approach. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e671 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michele Potenzoni Fidenza, Italy More articles by this author Andrea Prati Fidenza, Italy More articles by this author Luigi Benecchi Cremona, Italy More articles by this author Antonio Savino Fidenza, Italy More articles by this author Annamaria Pieri Fidenza, Italy More articles by this author Daniel Martens Fidenza, Italy More articles by this author Sergio Carmelo Destro Pastizzaro Fidenza, Italy More articles by this author Nicoletta Uliano Fidenza, Italy More articles by this author Rodolfo Passalacqua Cremona, Italy More articles by this author Domenico Potenzoni Fidenza, Italy More articles by this author Brighenti Matteo Cremona, Italy More articles by this author Donini Maddalena Cremona, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...