Korean J Urol.  2007 Nov;48(11):1116-1120. 10.4111/kju.2007.48.11.1116.

Safety of Adjuvant Chemotherapy after Orthotopic Bladder Substitution: Comparison to Ileal Conduit

• Kim KT
• Yeo WG
• Lee E

• KMID: 1997086
• DOI: http://doi.org/10.4111/kju.2007.48.11.1116

Abstract

PURPOSE: Radical cystectomy with urinary tract reconstruction currently remains the standard treatment for invasive bladder cancer, and adjuvant chemotherapy is usually considered for patients with a clinical stage >T2 or nodal metastasis. The aim of this study was to assess the safety of adjuvant chemotherapy in patients with orthotopic bladder substitution in comparison to ileal conduit.
MATERIALS AND METHODS
We retrospectively analyzed the patients who underwent radical cystectomy and urinary diversion between 1990 and 2005. The patients who underwent adjuvant chemotherapy were stratified into two groups: those who had orthotopic bladder substitution and those who had ileal conduit. The chemotherapy regimen, renal function change, complications from adjuvant chemotherapy and other relevant data were analyzed.
RESULTS
Overall, 341 patients had radical cystectomy, 89 had adjuvant chemotherapy, 28 had orthotopic bladder substitution and 61 had ileal conduit. The patient characteristics, including age, stage and follow-up, were similar in both groups. In all, 42% of patients had grade 1 toxicity, 16% had grade 2, 14% had grade 3 and 0% had grade 4. No patients had serious organ toxicity and none died. There were no significant differences in the chemotherapy toxicity and renal function change among the two groups.
CONCLUSIONS
Adjuvant chemotherapy is safe and well tolerated by patients with either orthotopic bladder substitution or ileal conduit. There was no increased morbidity or mortality due to adjuvant chemotherapy in the patients who had orthotopic bladder substitution. Hence, orthotopic bladder substitution should not be denied to those patients with bladder cancer and who might require adjuvant chemotherapy.

Keyword

Adjuvant chemotherapy; Urinary diversion; Cystectomy; Bladder cancer

MeSH Terms

Chemotherapy, Adjuvant*
Cystectomy
Drug Therapy
Follow-Up Studies
Humans
Mortality
Neoplasm Metastasis
Retrospective Studies
Urinary Bladder Neoplasms
Urinary Bladder*
Urinary Diversion*
Urinary Tract

Figure

• 

  Fig. 1 The distribution of toxicity types (p=0.81).

• 

  Fig. 2 The distribution of toxicity grades (p=0.90).

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