Abstract
Background: Neoadjuvant chemotherapy demonstrated a survival benefit versus cystectomy alone in muscle-invasive urothelial bladder cancer. Despite this advantage, preoperative chemotherapy is not widely employed. When patients are unfit for cisplatin-based regimen, they are often candidates for immediate surgery. In our study, patients with muscle-invasive bladder cancer were treated with neoadjuvant chemotherapy. The principal objective was the rate of complete pathological response (PCR). Secondary end-points were disease-free survival (DFS), overall survival (OS) and toxicity. Patients and Methods: Patients (n=72) with Eastern Cooperative Oncology Group (ECOG) performance status 0-1, clinical stage cT3-4, and/or N+ muscle-invasive bladder cancer were enrolled. The chemotherapy regimen was established according to the cisplatin feasibility. Thirty patients were treated with cisplatin/gemcitabine (Gem) and 42 with carboplatin/Gem. Results: The rate of PCR was 29.2%, 36% with cisplatin-based treatment and 23.8% with carboplatin (p=0.3574). DFS and OS were longer in PCR patients, while no difference was reported between cisplatin/Gem and Carboplatin/Gem groups. Conclusion: Our results confirm the prognostic value of PCR in neoadjuvant chemotherapy for muscle-invasive bladder cancer. When the patients are not fit for cisplatin, a carboplatin/Gem regimen represents a valid option because of comparable long-term outcome. When cisplatin is not feasible, the exclusion of a preoperative treatment is not justified.
Lingua originale | English |
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pagine (da-a) | 6453-6458 |
Numero di pagine | 6 |
Rivista | Anticancer Research |
Volume | 37 |
DOI | |
Stato di pubblicazione | Pubblicato - 2017 |
Keywords
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols
- Cancer Research
- Carboplatin
- Carcinoma, Transitional Cell
- Cisplatin
- Cystectomy
- Deoxycytidine
- Disease-Free Survival
- Feasibility Studies
- Female
- Humans
- Male
- Middle Aged
- Neoadjuvant
- Neoadjuvant Therapy
- Oncology
- Pathological response
- Prospective Studies
- Survival Analysis
- Treatment Outcome
- Urinary Bladder Neoplasms
- Urothelial bladder cancer