[Intra-arterial chemotherapy with cisplatin in advanced urothelial cancer]

Thirty-two patients with advanced bladder cancer received intraarterial infusion of chemotherapy with cis-platin (CDDP). For twenty-one patients, the intraarterial infusion was carried out using Seldinger's method. On the other hand, for the eleven patients who were diagnosed as inoperable cases, the intraarterial infusion was carried out using the reservoir system. The mean regression in the size of the tumor was 64%, which was statistically superior to the mean regression in the intravenous administration group, was 45%. According to Shimosato's criteria, the pathological response was evaluated. Seven patients (22%) were detected as having more than grade III. On the other hand, among the intravenous administration group, only one case (11%) was detected as more than grade III. Following the intraarterial infusion of chemotherapy, subsequent surgical treatment was performed on 21 patients. Fourteen patients underwent the organ-preserving operation, either transurethral resection or segmental resection of the bladder, and seven patients underwent radical cystectomy. In seventeen patients (53%), there was no evidence of the disease. Especially, eleven patients (79%) who under went the organ-preserving operation had no evidence of the disease. The intraarterial infusion method of chemotherapy with CDDP showed a high response, both in terms of regression of tumor size and the pathological degeneration, compared to intravenous administration of CDDP. The subsequent surgical treatment following chemotherapy issues not only a better survival rate, but also makes possible preservation of organs.