Abstract
BackgroundAdenocarcinoma of the urinary bladder is a rare malignancy. Radical surgery is suggested as the best available treatment for early-stage disease, but there is currently no consensus on standard chemotherapy regimen for advanced stage. We assessed the feasibility and effect of neoadjuvant chemotherapy with gemcitabine and cisplatin (GC) plus S-1 for patients with locally advanced primary adenocarcinomas of the urinary bladder.MethodsSix patients with locally advanced urachal or non-urachal (n = 3, each) primary adenocarcinoma of the bladder were treated from October 2010 to October 2013 at a single center. All the patients were treated with 3 cycles (21d, each) of GC plus S-1 (gemcitabine, 1000 mg/m2, days 1 and 8; cisplatin, 70 mg/m2, day 2; and S-1, 50 mg bid, day 1-14). After neoadjuvant chemotherapy, patients with urachal cancer were treated with en bloc radical cystectomy and umbilectomy; the remaining 3 patients were treated with cystectomy.ResultsAll patients successfully completed the neoadjuvant chemotherapy without serious side effects. Two patients were assessed as complete response, 2 as partial response, 1 as stable disease and 1 as progressive disease.ConclusionsDespite the limitations of a small study population, the GC plus S-1 regimen for locally advanced primary adenocarcinoma of the urinary bladder was effective, and facilitated the success of surgery to a certain extent. Short follow-up time was also a limitation of our study. More studies are needed to evaluate the results.
Highlights
Adenocarcinoma of the urinary bladder is a rare malignancy
Tumors were considered urachal if the tumor was located at the dome of the bladder rather than the anterior bladder wall, with the most critical features being the presence of a sharp demarcation between the tumor and the surface epithelium, and the exclusion of a primary adenocarcinoma elsewhere
The 3 patients with non-urachal adenocarcinoma were treated by cystectomy
Summary
Adenocarcinoma of the urinary bladder is a rare malignancy. Radical surgery is suggested as the best available treatment for early-stage disease, but there is currently no consensus on standard chemotherapy regimen for advanced stage. We assessed the feasibility and effect of neoadjuvant chemotherapy with gemcitabine and cisplatin (GC) plus S-1 for patients with locally advanced primary adenocarcinomas of the urinary bladder. Primary adenocarcinomas of the bladder account for less than 2% of primary bladder cancers, and are rarely encountered [1,2]. Radical surgery is considered the best available treatment, but the 5-year survival rates (11%61%) have not been satisfactory [3]. For patients with locally advanced primary locally advanced primary adenocarcinomas of the bladder, target lesion, from nadir) [9].
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