Korean J Urol.  2004 Jan;45(1):19-23.

Bladder Preservation Management for Muscle Invasive Bladder Cancer

Affiliations
  • 1Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea.

Abstract

PURPOSE: Although the gold standard treatment for muscle invasive bladder cancer, radical cystectomy does not guarantee a high survival rate even without the natural bladder. We evaluated the survival rate and prognostic factors in patients with muscle invasive transitional cell carcinoma of the bladder, performed with the combined modality of transurethral resection and chemotherapy.
MATERIALS AND METHODS
A total of 72 patients with clinical stage T2-T4 N0M0 bladder cancer diagnosed/treated/admitted between 1991 and 2002 were included in the study. They were treated with transurethral resection followed by 6 cycles of methotrexate, vinblastine, epirubicin, and cisplatin chemotherapy. The patients were evaluated with cystoscopy, urine cytology, abdominal-pelvic CT scan, whole body bone scan, and chest radiography. The prognostic factors such as age, the presence of hydronephrosis, and tumor stage, size, grade, and morphology were analyzed using log-rank test, while the 5-year overall survival rate was estimated using Kaplan-Meier method.
RESULTS
The 5-year overall survival rate was 48%(stage T2, 83%; stage T3, 60%; stage T4, 0%). Age, T stage, tumor grade and tumor size were significant predictors for an increased probability of bladder preservation. Tumor morphology and the presence of hydronephrosis were not associated with survival rate in bladder preservation management.
CONCLUSIONS
Our RESULTS showed that bladder preservation managed with transurethral resection and chemotherapy for muscle invasive bladder cancer demonstrates a good response rate in selected patients. Therefore, muscle invasive bladder cancer with T2-3 stage, low grade, small size(less than 4 cm), and solitary in patients less than 65 years old may be considered as a candidate for bladder preservation management.

Keyword

Bladder neoplasm; Organ preservation; Chemotherapy; Surgery

MeSH Terms

Aged
Carcinoma, Transitional Cell
Cisplatin
Cystectomy
Cystoscopy
Drug Therapy
Epirubicin
Humans
Hydronephrosis
Methotrexate
Organ Preservation
Radiography
Survival Rate
Thorax
Tomography, X-Ray Computed
Urinary Bladder Neoplasms*
Urinary Bladder*
Vinblastine
Cisplatin
Epirubicin
Methotrexate
Vinblastine
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