[The effectiveness of neoadjuvant chemotherapy for invasive bladder cancer]

Sixteen patients with invasive bladder cancer were received neoadjuvant methotrexate, vinblastine, pirarubicin and cisplatin chemotherapy on our planning protocol.

The tumor was evaluated after 1 course of chemotherapy by radiographic examination, urine cytology, cystoscopy and random biopsy. If the response is CR or PR, one more course of chemotherapy was performed, and cystectomy was carried out. If the response is NC or PD, cystectomy was immediately carried out. Twelve of them were underwent cystectomy and four were preserved bladder. Clinical response was evaluated by echo, CT, MRI, urinary cytology, cystoscopy and random biopsy.

Clinical CR was observed in 25% and PR was 37.5%. Pathological CR was observed in 31.3% and PR was 37.5%. The different rate between clinical and pathological evaluations was 31.3% and the result suggests that we should find the method of more accurate staging evaluation. Four patients who were evaluated clinical CR were selected bladder-preserving. However, two of them (50%) had recurred; one had grade 3 tumor was treated by total cystectomy and the other had multiple tumors was treated by one course of M-VAC and TUR-Bt.

We should consider which cases are possible to preserve bladder by investigating the tumor characteristics.