J Korean Med Sci.  2008 Aug;23(4):598-603. 10.3346/jkms.2008.23.4.598.

Single Institutional Experience of Bladder-Preserving Trimodality Treatment for Muscle-Invasive Bladder Cancer

• Joung JY
• Han KS
• Kim TS
• Seo HK
• Chung J
• Lee KH

• KMID: 1785816
• DOI: http://doi.org/10.3346/jkms.2008.23.4.598

Abstract

The authors designed this study to determine the clinical effectiveness of trimodality treatment, i.e., transurethral resection of a bladder tumor (TURBT) and concurrent chemoradiotherapy (CRT). Twenty patients with a muscle-invasive bladder cancer were treated by TURBT followed by concurrent cisplatin (75 mg/m(2) day), administered on weeks 1 and 4 of radiotherapy. According to residual tumor status after TURBT, patients were classified into patients with a complete TURBT group and incomplete TURBT group. Response to treatment was evaluated by restaging TURBT at 4 weeks after completing CRT (post-CRT). Fifteen patients (75%) achieved complete remission (CR) at restaging; 10 patients (50%) remained continuously free of tumor recurrence. Disease-specific and overall survivals were 51.1% and 38.6% at 5 yr post-CRT, respectively. Of 16 patients in the complete TURBT group, 14 patients (87.5%) achieved CR, which was significantly different from that observed in the incomplete TURBT group, in which only 1 (25%) of 4 patients achieved CR (p=0.032). Five- year disease-specific and overall survivals were 71.6% and 53.5%, respectively. Ten patients (90.9%) maintained their own bladder among the 11 surviving patients. Trimodality treatment was found to be an effective treatment in patients who underwent complete TURBT for a muscle-invasive bladder cancer.

Keyword

Urinary Bladder Neoplasms; Cisplatin; Combined Modality Treatment

MeSH Terms

Cisplatin/therapeutic use
Combined Modality Therapy
Female
Humans
Male
Muscle Neoplasms/pathology
Neoplasm Invasiveness
Salvage Therapy
Urinary Bladder Neoplasms/mortality/pathology/*therapy

Figure

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  Fig. 1 Treatment outcomes. TURBT, transurethral resection of bladder tumor; CR, complete remission, PIT, persistent invasive tumor; recur, recurrence; Ds, disease.

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  Fig. 2 Kaplan-Meier estimates of likelihood of overall survival (A) and disease-specific survival (B) for patients with complete TURBT vs. incomplete TURBT.

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