Abstract
Study Type - Prognosis (case series) Level of Evidence 4 Objective To determine the survival of patients at our institution who were clinically tumour-free (cT0) on re-staging transurethral resection (TUR) after treatment with chemotherapy for muscle-invasive bladder cancer. Patients and Methods In all, 55 patients with muscle-invasive, organ-confined transitional cell carcinoma of the bladder were treated with TUR followed by systemic chemotherapy, over a 10-year period. Patients were separated into two groups, those who were clinically T0 and those who showed persistent disease (>cT0) on re-biopsy after chemotherapy. Overall and disease-specific survival rates were calculated for the two groups. The cT0 group was further followed for tumour recurrence and clinical outcomes. Results Thirty-one patients (56%) were clinically T0 on TUR after chemotherapy; of these patients, 22 (71%) either died from other causes (with no disease recurrence) or are alive and with no evidence of disease at a mean follow-up of 53 months. Twenty of the 31 patients (65%) have retained their bladder with no evidence of cancer recurrence at a mean follow-up of 46 months. Disease-free status (cT0) at the time of TUR after chemotherapy was associated with significantly higher overall and cancer-specific survival (hazard ratio 3.40, P = 0.003; and 8.63, P = 0.001, respectively). Conclusion Previous studies suggest that surveillance can be a reasonable option for patients with muscle-invasive transitional cell carcinoma of the bladder who show no evidence of disease on TUR after chemotherapy. Patients with persistent bladder cancer on re-biopsy after chemotherapy tend to fare poorly even with immediate cystectomy.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 485-488 |
| Number of pages | 4 |
| Journal | BJU International |
| Volume | 105 |
| Issue number | 4 |
| DOIs | |
| State | Published - Feb 2010 |
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Keywords
- Bladder cancer
- Chemotherapy
- Surveillance
- Survival
ASJC Scopus subject areas
- Urology
Cite this
The role of surveillance in the treatment of patients with muscle-invasive bladder cancer after chemotherapy. / Hellenthal, Nicholas J.; Ramirez, Michelle L.; Evans, Christopher P; deVere White, Ralph W.
In: BJU International, Vol. 105, No. 4, 02.2010, p. 485-488.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The role of surveillance in the treatment of patients with muscle-invasive bladder cancer after chemotherapy
AU - Hellenthal, Nicholas J.
AU - Ramirez, Michelle L.
AU - Evans, Christopher P
AU - deVere White, Ralph W
PY - 2010/2
Y1 - 2010/2
N2 - Study Type - Prognosis (case series) Level of Evidence 4 Objective To determine the survival of patients at our institution who were clinically tumour-free (cT0) on re-staging transurethral resection (TUR) after treatment with chemotherapy for muscle-invasive bladder cancer. Patients and Methods In all, 55 patients with muscle-invasive, organ-confined transitional cell carcinoma of the bladder were treated with TUR followed by systemic chemotherapy, over a 10-year period. Patients were separated into two groups, those who were clinically T0 and those who showed persistent disease (>cT0) on re-biopsy after chemotherapy. Overall and disease-specific survival rates were calculated for the two groups. The cT0 group was further followed for tumour recurrence and clinical outcomes. Results Thirty-one patients (56%) were clinically T0 on TUR after chemotherapy; of these patients, 22 (71%) either died from other causes (with no disease recurrence) or are alive and with no evidence of disease at a mean follow-up of 53 months. Twenty of the 31 patients (65%) have retained their bladder with no evidence of cancer recurrence at a mean follow-up of 46 months. Disease-free status (cT0) at the time of TUR after chemotherapy was associated with significantly higher overall and cancer-specific survival (hazard ratio 3.40, P = 0.003; and 8.63, P = 0.001, respectively). Conclusion Previous studies suggest that surveillance can be a reasonable option for patients with muscle-invasive transitional cell carcinoma of the bladder who show no evidence of disease on TUR after chemotherapy. Patients with persistent bladder cancer on re-biopsy after chemotherapy tend to fare poorly even with immediate cystectomy.
AB - Study Type - Prognosis (case series) Level of Evidence 4 Objective To determine the survival of patients at our institution who were clinically tumour-free (cT0) on re-staging transurethral resection (TUR) after treatment with chemotherapy for muscle-invasive bladder cancer. Patients and Methods In all, 55 patients with muscle-invasive, organ-confined transitional cell carcinoma of the bladder were treated with TUR followed by systemic chemotherapy, over a 10-year period. Patients were separated into two groups, those who were clinically T0 and those who showed persistent disease (>cT0) on re-biopsy after chemotherapy. Overall and disease-specific survival rates were calculated for the two groups. The cT0 group was further followed for tumour recurrence and clinical outcomes. Results Thirty-one patients (56%) were clinically T0 on TUR after chemotherapy; of these patients, 22 (71%) either died from other causes (with no disease recurrence) or are alive and with no evidence of disease at a mean follow-up of 53 months. Twenty of the 31 patients (65%) have retained their bladder with no evidence of cancer recurrence at a mean follow-up of 46 months. Disease-free status (cT0) at the time of TUR after chemotherapy was associated with significantly higher overall and cancer-specific survival (hazard ratio 3.40, P = 0.003; and 8.63, P = 0.001, respectively). Conclusion Previous studies suggest that surveillance can be a reasonable option for patients with muscle-invasive transitional cell carcinoma of the bladder who show no evidence of disease on TUR after chemotherapy. Patients with persistent bladder cancer on re-biopsy after chemotherapy tend to fare poorly even with immediate cystectomy.
KW - Bladder cancer
KW - Chemotherapy
KW - Surveillance
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=76149127366&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=76149127366&partnerID=8YFLogxK
U2 - 10.1111/j.1464-410X.2009.08905.x
DO - 10.1111/j.1464-410X.2009.08905.x
M3 - Article
C2 - 19849694
AN - SCOPUS:76149127366
VL - 105
SP - 485
EP - 488
JO - BJU International
JF - BJU International
SN - 1464-4096
IS - 4
ER -