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An Orthotopic Bladder Tumor Model and the Evaluation of Intravesical saRNA Treatment
Published on: July 28, 2012
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
Summary
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.
- 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.
