Clinical effect of Radical TUR-BT combined with intra-arterial chemotherapy for localized muscle-invasive bladder cancer

Abstract

Objective To evaluate the clinical efficacy of Radical TUR-BT combined with intra-arterial chemotherapy in the treatment of stage T2N0M0 localized muscle-invasive bladder cancer (MIRC). Methods The clinical data of 91 patients with T2N0M0 localized myometrial invasive bladder cancer admitted from January 2010 to December 2015 in the people′s Hospital of Xinjiang Uyghur Autonomous Region were retrospectively analyzed, 76 cases were males, 15 cases were female, average age was 63.2 years old, age range 39-91 years old. Patients were divided into BPT group (n=34) and RC group (n=57) according to different surgical methods. Patients in the BPT group underwent Radical TUR-BT+ intra-arterial chemotherapy, and patients in the RC group underwent radical cystectomy + urinary diversion. The median follow-up time, 2-year progression-free survival, 5-year disease-specific survival rate, overall survival and Karnofsky performance status (KPS) were compared between the two groups. Measurement data were expressed as mean±standard deviation (Mean±SD), t test was used for comparison between groups; and Chi-square test was used to compare the count date between groups.Using Kaplan-Meier method to depict disease-specific survival time in two groups. Quality of life evaluation using Karnofsky score, Evaluate the quality of life and health status of the two groups 3 months before and after treatment. Results The median follow-up time of BPT group and RC group were 35 months and 33 months. The 2-year progression-free rates in the BPT and RC groups were 73.5% and 75.4%, respectively, and the difference was not statistically significant (P=0.758). The 5-year disease-specific survival rates of the two groups were 72.4% and 74.8%, respectively, and the difference was not statistically significant (P=0.780). The overall survival rates of the two groups were 61.8% and 63.2%, respectively, and the difference was not statistically significant (P=0.103). There was no significant difference in preoperative KPS score between the two groups (P=0.652). The KPS score of the BPT group was significantly higher than that of the RC group at 3 months after surgery. The difference was statistically significant(P=0.034). Conclusions For patients with localized MIBC with clinical stage of T2N0M0. Radical TUR-BT combined with intra-arterial chemotherapy has similar effects to RC. This treatment can effectively improve the prognosis, preserve the bladder, and improve the quality of life for patients. Key words: Urinary bladder neoplasms; Antineoplastic combined chemotherapy protocols; Comparative effectiveness research