Adjuvant chemotherapy for uroepithelial transitional cell carcinoma.

Area of Science:

• Urology
• Oncology
• Medical Oncology

Background:

• Transitional cell carcinoma (TCC) of the bladder (T1/G3 and ≥T2) and upper urinary tract requires effective treatment strategies.
• Adjuvant chemotherapy's role in improving outcomes for these urothelial cancers is under investigation.

Purpose of the Study:

• To evaluate the effectiveness of adjuvant chemotherapy in patients with TCC of the bladder and upper urinary tract.
• To compare survival duration and disease-free intervals between chemotherapy and non-chemotherapy groups.

Main Methods:

• A cohort of 136 patients with TCC underwent complete tumor resection.
• Patients were divided into chemotherapy (n=59) and non-chemotherapy (n=49) groups.
• Chemotherapy regimens included various combinations of 5-fluorouracil, vincristine, bleomycin, peplomycin, mitomycin C, cyclophosphamide, adriamycin, cis-platinum, methotrexate, and vinblastine.

Main Results:

• The 5-year survival rates were 76.3% (bladder) and 78.2% (upper tract) in the chemotherapy group, versus 62.7% (bladder) and 67.3% (upper tract) in the non-chemotherapy group.
• Disease-free intervals were significantly longer in the chemotherapy group for bladder cancer patients (24.6+ vs. 21.1+ months, P<0.05).
• Recurrence rates were significantly lower in the chemotherapy group (25%) compared to the non-chemotherapy group (65%, P<0.001).

Conclusions:

• Adjuvant chemotherapy may be effective in extending survival for urothelial TCC.
• Chemotherapy significantly prolongs the disease-free period, especially in advanced bladder cancer.
• Reported side effects were generally well tolerated.