Premium
Prognostic significance of adjuvant cisplatin‐based combination chemotherapy following radical cystectomy in patients with invasive bladder cancer
Author(s) -
Muramaki Mototsugu,
Miyake Hideaki,
Kurahashi Toshifumi,
Takenaka Atsushi,
Inoue TakaAki,
Fujisawa Masato
Publication year - 2008
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2008.02000.x
Subject(s) - medicine , cystectomy , bladder cancer , oncology , vinblastine , cisplatin , cancer , chemotherapy , urology
Objectives: The objectives of this study were to retrospectively examine the outcomes of adjuvant cisplatin‐based combination chemotherapy following radical cystectomy in patients with invasive bladder cancer in order to identify parameters predicting the prognosis of these patients. Methods: This study included a total of 51 patients with muscle invasive bladder cancer who underwent radical cystectomy between January 1995 and December 2004, and subsequently received at least two cycles of either MVAC (methotrexate, vinblastine, doxorubicin and cisplatin) or MVP‐CAB (methotrexate, doxorubicin, vincristine, cyclophosphamide, bleomycin and cisplatin) chemotherapy in an adjuvant setting because of the presence of diseases corresponding to pT3/4 and/or pN1/2 without clinical evidence of metastasis. The significance of several clinicopathological factors as predictors of disease recurrence and cancer‐specific death was evaluated using univariate and multivariate analyses. Results: During the observation period of this study (median, 26.5 months), disease‐recurrence and cancer‐specific death were observed in 21 and 16 patients, respectively. The 5‐year recurrence‐free and cancer‐specific survival rates were 48.6% and 54.1%, respectively. Among several factors examined in this series, lymph node metastasis and concomitant carcinoma in situ (CIS) were identified as significant predictors of both disease‐recurrence and cancer‐specific death, and these were also independently associated with disease‐recurrence and cancer‐specific death. Conclusions: Adjuvant cisplatin‐based combination chemotherapy for patients with extravesically extended bladder cancer following radical cystectomy resulted in comparatively unsatisfactory outcome concerning cancer‐control; accordingly, it would be necessary to develop a more efficacious therapeutic strategy for such patients, particularly for those with lymph node metastasis and/or concomitant CIS.