MP21-04 THE EFFICACY OF TRIMODAL CHEMORADIOTHERAPY AS A BLADDER-PRESERVING STRATEGY FOR MUSCLE INVASIVE BLADDER CANCER

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive I1 Apr 2017MP21-04 THE EFFICACY OF TRIMODAL CHEMORADIOTHERAPY AS A BLADDER-PRESERVING STRATEGY FOR MUSCLE INVASIVE BLADDER CANCER Kazuhiro Nagao, Takahiko Hara, Jun Nishijima, Junichi Mori, Kosuke Shimizu, Nakanori Fujii, Keita Kobayashi, Yoshihisa Kawai, Ryo Inoue, Yoshiaki Yamamoto, Hiroaki Matsumoto, and Hideyasu Matsuyama Kazuhiro NagaoKazuhiro Nagao More articles by this author , Takahiko HaraTakahiko Hara More articles by this author , Jun NishijimaJun Nishijima More articles by this author , Junichi MoriJunichi Mori More articles by this author , Kosuke ShimizuKosuke Shimizu More articles by this author , Nakanori FujiiNakanori Fujii More articles by this author , Keita KobayashiKeita Kobayashi More articles by this author , Yoshihisa KawaiYoshihisa Kawai More articles by this author , Ryo InoueRyo Inoue More articles by this author , Yoshiaki YamamotoYoshiaki Yamamoto More articles by this author , Hiroaki MatsumotoHiroaki Matsumoto More articles by this author , and Hideyasu MatsuyamaHideyasu Matsuyama More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.3266AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the bladder preservation strategy used at our institution for muscle-invasive bladder cancer (MIBC) in patients undergoing chemoradiotherapy. METHODS In 71 patients with MIBC, transurethral resection of the bladder tumor was performed before treatment to confirm pathological stage =T2. Fifty patients received cisplatin-radiation (CDDP-R) therapy and 21 received gemcitabine plus cisplatin-radiation (GC-R) therapy. Extensive transurethral resection of bladder tumors was performed after chemoradiotherapy to evaluate the pathological response to treatment. We used propensity score-match analysis to compare the oncological outcomes of patients treated by chemoradiotherapy to those of patients treated by open radical cystectomy (ORC). RESULTS The 2- and 5-year progression-free survival (PFS), bladder-intact survival (BIS), cancer-specific survival (CSS), and overall survival rates after treatment were 71.6% and 66.1%, 68.9% and 56.1%, 85.1% and 72.5%, and 83.3% and 66.6%, respectively. The complete response (CR) after chemoradiotherapy could be a good predictor of PFS, BIS, and CSS (OR = 0.31, p < 0.05; OR = 0.22, p < 0.01; OR = 0.11, p < 0.005, respectively) and clinical stage T2 could be a significant predictor of good BIS and CSS (OR = 0.28, p < 0.05 and, OR = 0.21, p < 0.05, respectively). The response to GC-R was significantly better than that to CDDP-R (CR: 81% vs. 29.4%), with tolerable adverse events. According to our propensity score-match analysis, the 2- and 5-year overall survival rates after chemoradiotherapy were 89.2 and 78.9%, respectively, and those after ORC were 82.3 and 69.6%, respectively, indicating comparable survival benefit of chemoradiotherapy to that of ORC. CONCLUSIONS Bladder preservation by chemoradiotherapy for MIBC is as effective as radical cystectomy. GC-R treatment might be more effective with better cancer control than CDDP-R. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e249 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Kazuhiro Nagao More articles by this author Takahiko Hara More articles by this author Jun Nishijima More articles by this author Junichi Mori More articles by this author Kosuke Shimizu More articles by this author Nakanori Fujii More articles by this author Keita Kobayashi More articles by this author Yoshihisa Kawai More articles by this author Ryo Inoue More articles by this author Yoshiaki Yamamoto More articles by this author Hiroaki Matsumoto More articles by this author Hideyasu Matsuyama More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...