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Related Experiment Videos

Invasive bladder cancer: a single-institution experience with bladder-sparing approach.

A Zapatero1, C Martín de Vidales, A Marín

  • 1Department of Radiation Oncology, Hospital Universitario de la Princesa, Madrid, Spain. azapat@ene.es

International Journal of Cancer
|November 25, 2000
PubMed
Summary

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This study shows that transurethral resection and chemoradiotherapy can preserve the bladder in muscle-invasive bladder cancer patients. This bladder-preserving approach offers an effective alternative to radical cystectomy for selected individuals.

Area of Science:

  • Urology
  • Oncology
  • Radiation Oncology

Background:

  • Muscle-invasive bladder cancer (MIBC) poses significant treatment challenges.
  • Radical cystectomy is the standard treatment but involves substantial morbidity.
  • Bladder preservation strategies are sought to improve quality of life for MIBC patients.

Purpose of the Study:

  • To evaluate the efficacy and safety of a bladder-preserving treatment for MIBC.
  • To assess outcomes of transurethral resection (TUR) combined with sequential chemoradiotherapy.
  • To compare this approach with radical cystectomy in selected MIBC patients.

Main Methods:

  • 40 patients with clinical stages T2-4NxM0 MIBC underwent aggressive TUR.
  • Induction chemotherapy with methotrexate, cisplatin, and vinblastine (MCV) followed TUR.

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  • Complete responders received sequential radiotherapy (60 Gy bladder, 50 Gy pelvic nodes).
  • Radical cystectomy was reserved for patients with residual tumor.

    • Main Results:

    • A 70% clinical complete response rate was observed after TUR and MCV chemotherapy.
    • The 4-year overall survival rate for the entire cohort was 80.5%.
    • Among patients completing chemoradiotherapy, 4-year survival was 84%, with 82.6% maintaining their bladders.
    • Freedom from local failure was 84% in complete responders.
    • Extent of initial TUR and post-chemotherapy status were independent prognostic factors for survival.

    Conclusions:

    • A bladder-preserving approach combining aggressive TUR and sequential chemoradiotherapy is a viable alternative to radical cystectomy for selected MIBC patients.
    • This strategy achieves high survival rates and bladder preservation.
    • Further research should focus on refining patient selection and optimizing treatment protocols.