PD27-07 BLADDER-SPARING PROTOCOL CONSISTING OF LOW-DOSE CHEMORADIOTHERAPY AND CONSOLIDATIVE PARTIAL CYSTECTOMY AGAINST MUSCLE-INVASIVE BLADDER CANCER: COMPARISON OF ONCOLOGICAL AND FUNCTIONAL OUTCOMES BETWEEN OLDER AND YOUNGER PATIENTS

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive II1 Apr 2016PD27-07 BLADDER-SPARING PROTOCOL CONSISTING OF LOW-DOSE CHEMORADIOTHERAPY AND CONSOLIDATIVE PARTIAL CYSTECTOMY AGAINST MUSCLE-INVASIVE BLADDER CANCER: COMPARISON OF ONCOLOGICAL AND FUNCTIONAL OUTCOMES BETWEEN OLDER AND YOUNGER PATIENTS Yasuhisa Fujii, Kazunori Kihara, Hajime Tanaka, Kazutaka Saito, Soichiro Yoshida, Minato Yokoyama, Junichiro Ishioka, Yoh Matsuoka, and Noboru Numao Yasuhisa FujiiYasuhisa Fujii More articles by this author , Kazunori KiharaKazunori Kihara More articles by this author , Hajime TanakaHajime Tanaka More articles by this author , Kazutaka SaitoKazutaka Saito More articles by this author , Soichiro YoshidaSoichiro Yoshida More articles by this author , Minato YokoyamaMinato Yokoyama More articles by this author , Junichiro IshiokaJunichiro Ishioka More articles by this author , Yoh MatsuokaYoh Matsuoka More articles by this author , and Noboru NumaoNoboru Numao More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.381AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We evaluated oncological and functional outcomes of muscle-invasive bladder cancer (MIBC) treatment with our bladder-sparing protocol consisting of transurethral resection of bladder tumor (TURB), low-dose chemoradiotherapy (LCRT), and consolidative partial cystectomy (PC) (Urol Oncol 2013, BJU Int 2012, 2009), comparing outcomes in elderly and younger patients. METHODS This study included 143 patients with cT2-4aN0M0 MIBC whose tumors met all of the following criteria: 1) solitary and circumscribed within ≤25% of the bladder area, 2) not involving the bladder neck, 3) no broad carcinoma in situ and who were treated with our bladder-sparing protocol. After debulking TURB followed by LCRT (radiation at 40 Gy concurrently with two cycles of intravenous cisplatin at 20 mg/day for five days), the patients showing no massive residual disease were final candidates for bladder preservation with consolidative PC. The other patients were recommended for radical cystectomy. Oncological and functional outcomes were compared between patients ≥75 years of age (N=46) and those <75 years (N=97) using the following endpoints: bladder preservation rate, MIBC recurrence-free survival (MIBC-RFS), cancer-specific survival (CSS), overall survival (OS), cross-sectional assessments of urinary function and QoL using uroflowmetry, bladder diary, I-PSS, OABSS, ICIQ-SF, and SF-36. RESULTS Median follow-up period was 41 months. Of the 46 elderly and 97 younger patients, 40 (87%) and 75 (77%), respectively, were final candidates for bladder preservation (P=0.83), and 32 (70%) and 59 (61%) actually completed the bladder sparing protocol including PC (P=0.31). Among those patients who completed the protocol, five-year MIBS-RFS, CSS, and OS rates were 100% and 98%, 90% and 98%, and 85% and 96% in the elderly and younger patients, respectively (P=0.17, 0.11, and 0.07, respectively). Uroflowmetry revealed mean residual urine volumes of 25 and 18 ml (P=0.80) in elderly and younger patients, respectively. Bladder diary indicated median maximum voided volume of 355 ml (P=0.60) in both groups. Other urinary function and QoL tests demonstrated favorable outcomes in both groups. Among all 143 patients, five-year OS rates were 75% and 74% in elderly and younger patients, respectively (P=0.48). CONCLUSIONS Our bladder-sparing strategy achieved favorable long-term oncological and functional outcomes for elderly patients as well as for younger patients. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e652 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Yasuhisa Fujii More articles by this author Kazunori Kihara More articles by this author Hajime Tanaka More articles by this author Kazutaka Saito More articles by this author Soichiro Yoshida More articles by this author Minato Yokoyama More articles by this author Junichiro Ishioka More articles by this author Yoh Matsuoka More articles by this author Noboru Numao More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...