Gemcitabine plus cisplatin neoadjuvant chemotherapy with radical cystectomy for the treatment of muscle invasive bladder cancer: 9 years retrospective analysis

Abstract

Objective To assess the value of gemcitabine plus cisplatin (GC) neoadjuvant chemotherapy with radical cystectomy in the treatment of patients with muscle invasive bladder cancer (MIBC).Methods The data of 114 patients with MIBC received GC neoadjuvant chemotherapy with radical cystectomy from December 2003 to December 2012 were retrospectively compared with those in other 120 patients treated with radical cystectomy alone from June 2003 to December 2012 in our institution.There was no significant difference of the gender,age and stage between the 2 groups (P＞0.05).The duration of free survival,overall survival and the local control of tumor in different groups were compared.Results In the chemotherapy group,76 cases were found downstaging of the tumor after the operation,including 27 cases with tumor free.The mean duration of following up was (51 ±25) months.Forty-three patients died during the follow-up period.The median survival was 79 months and the 2-year recurrence free rate was 75.9％.In surgery alone group,23 cases were found downstaging of the tumor,including 5 cases with tumor free.The patients were followed up for (38±20) months.Fifty-seven patients died during the following up.The median survival was 44 months and the 2-year recurrence free rate was 62.8％.There were significant differences in downstaging rate of the tumor,recurrence free survival and overall survival between the 2 groups (P＜0.05).Conclusion GC neoadjuvant chemotherapy can improve survival of the patients with MIBC,which facilitate to downstage the tumor and increase the recurrence free survival duration and overall survival duration. Key words: Urinary bladder neoplasms; Muscle invasive; Antineoplastic combined chemotherapy protocols; Neoadjuvant chemotherapy; Gemcitabine plus cisplatin