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Balloon‐occluded arterial infusion as a useful neoadjuvant chemotherapy for bladder cancer
Author(s) -
ARIMA K.,
TOCHIGI H.,
SUGIMURA Y.,
KAWAMURA J.
Publication year - 1997
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1046/j.1464-410x.1997.00355.x
Subject(s) - medicine , stage (stratigraphy) , chemotherapy , bladder cancer , cancer , surgery , biology , paleontology
Objective To evaluate the balloon‐occluded arterial infusion (BOAI) of cisplatin and adriamycin as a pre‐operative adjuvant chemotherapy in patients with bladder cancer of stage ≥T2 or in those with stage T1 and multiple large tumours. Patients and methods The study comprised 120 patients with bladder cancer who underwent BOAI from November 1984 to December 1995. BOAI chemotherapy (adriamycin and cisplatin) was administered under ischaemia through a 7 F torque‐control balloon catheter, both sides of which were inserted into the contralateral internal iliac artery. The regression rate of tumours and any improvement in tumour stage was assessed. Results The clinical response rate (complete or partial) was 66% and the tumour stage improved in 39% of the patients after BOAI. Of 26 patients with stage T3a diagnosed before BOAI, 12 were diagnosed as T2 or less after treatment. Of 27 patients who underwent total cystectomy because the tumour was diagnosed as T2 after BOAI, the post‐operative histopathological examination showed that 22 (82%) were stage pT1 or below. The features associated with a good response to BOAI in patients with up to pT3a disease were grade 3, non‐papillary tumours with a diameter of <3 cm. Conclusion In patients diagnosed as stage T2 and T3a, or stage T1 with multiple large tumours difficult to be treat by transurethral resection, BOAI should be considered as the first choice to decrease the stage or to confirm the pathological staging.