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Forschungsdatenbank PMU-SQQUID

Neoadjuvant chemotherapy (MVAC) in locally invasive bladder cancer.
Sagaster, P; Flamm, J; Flamm, M; Mayer, A; Donner, G; Oberleitner, S; Havelec, L; Lepsinger, L; Ludwig, H;
Eur J Cancer. 1996; 32A(8):1320-1324
Originalarbeiten (Zeitschrift)

PMU-Autor/inn/en

Flamm Maria

Abstract

In order to evaluate the efficacy of neoadjuvant chemotherapy in invasive urothelial carcinoma of the bladder a retrospective analysis was performed. 54 patients without distant metastases (T2-T3b, N0-X, M0) received 3 cycles of neoadjuvant chemotherapy according to the MVAC protocol (methotrexate, vinblastine, doxorubicin and cisplatin) after transurethral resection (TUR) followed by cystectomy. 52 patients had previously undergone cystectomy immediately after TUR. Complete histopathological remission was observed in 9 patients (17.3%) after TUR and in 17 patients (31.5%) after TUR+MVAC. Neoadjuvant MVAC resulted, therefore, in a 14% higher rate of complete remissions. The overall response to TUR was significantly improved by MVAC therapy. Downstaging by neoadjuvant chemotherapy was more readily achieved in initially low-stage tumours (T2: 44.4% and 30.8%, T3a: 47.1% and 19%, T3b: 5.3% and 5.5% in patients receiving TUR+MVAC and TUR alone, respectively). Overall survival did not differ significantly between both groups. Patients who were successfully downstaged to pT0 had a significantly better prognosis, and patients resistant to chemotherapy had the poorest prognosis, showing the shortest survival. In conclusion, histopathological response at cystectomy was improved by neoadjuvant MVAC chemotherapy after TUR and can be expected to be prognostically relevant in those patients who can be downstaged to T0, although overall survival failed to be significantly increased in this relatively small patient sample.


Useful keywords (using NLM MeSH Indexing)

Aged

Antineoplastic Combined Chemotherapy Protocols/therapeutic use*

Carcinoma, Transitional Cell/drug therapy*

Carcinoma, Transitional Cell/pathology

Carcinoma, Transitional Cell/surgery

Chemotherapy, Adjuvant

Cisplatin/administration*

dosage

Cystectomy

Doxorubicin/administration*

dosage

Female

Humans

Male

Methotrexate/administration*

dosage

Middle Aged

Neoplasm Invasiveness

Retrospective Studies

Survival Rate

Urinary Bladder Neoplasms/drug therapy*

Urinary Bladder Neoplasms/pathology

Urinary Bladder Neoplasms/surgery

Vinblastine/administration*

dosage


Find related publications in this database (Keywords)

muscle-invasive bladder cancer
neoadjuvant chemotherapy
downstaging