The Efficacy and Toxicity of Adjuvant Gemcitabine-Cisplatin Chemotherapy in Patients with Advanced Bladder Cancer Underwent Radical Cystectomy

Abstract

Introduction: To evaluate the effect of gemcitabine-cisplatin as adjuvant chemotherapy in patients underwent radical cystectomy. Patients and Methods: A total of 25 patients with advanced bladder cancer with or without lymph node metastases (tumor stages pT2, pT3, pT4 and/or pN1, pN2) were evaluated between January 2001 and February 2006 for effectivity, toxic side-effects and overall survival. Patients received 4 cycles of a combination of gemcitabine 1,000 mg/ m² on days 1, 8, 15 and cisplatin 70 mg/m² on day 2, repeated every 4 weeks. Results: Median follow-up was 28.2 months. An average of 4.12 cycles of chemotherapy was administered. The median duration of survival for all the evaluable patients was 27.8 months. The overall survival was 86.4% at 1 year, 69.2% at 2 years and 54.5% at 3 years. Neutropenia and thrombocytopenia were clinically significant toxicities. Neutropenic fever was seen in 2 patients, and none died of sepsis. Conclusions: Better understanding of factors associated with postoperative outcomes associated with different types of chemotherapy in locally advanced bladder cancer is necessary. We conclude that gemcitabine-cisplatin regimen in adjuvant setting after cystectomy is feasible with a tolerable toxicity. But, randomized controlled trials will be required for the assessment of long-term benefit.