Adjuvant M-VAC Chemotherapy in Locally Advanced Bladder Cancer

Lee, Byung Tae; Park, Choal Hee; Kim, Chun Il

Abstract

The efficacy of adjuvant chemotherapy in locally advanced bladder cancer is still debated. Between March 1986 and February 1995, we retrospectively reviewed 25 patients with invasive, pathological stage P3b, P4 or N1 and M0 transitional cell carcinoma of the bladder who were treated with radical cystectomy alone (control group), adjuvant M-VAC chemotherapy after the surgery. The mean follow up period was 28 months. There were 13 patients in the control group and 12 in adjuvant chemotherapy group. The pathological stage distributions were P3b in 9 patients (5 in control group, 4 in chemotherapy group), P4 in 9 patients (5 in control group, 4 in chemotherapy group), N1 in 7 patients (3 in control group, 4 in chemotherapy group). Median survival times were 27 months in adjuvant chemotherapy group compared to 15 months in the control group, however they were not related statistically each other (P>0.05). The 2-year survival rates were 38% in control group, 70% in adjuvant chemotherapy group but they were not related statistically each other (P>0.05). We are not able to confirm the efficacy of adjuvant M-VAC chemotherapy in locally advanced bladder cancer. However adjuvant chemotherapy seems to have some beneficial effect. Controlled prospective clinical trials with large number of patients would be needed to assess the real efficacy of adjuvant M-VAC chemotherapy.