OBJETIVES: Radical cystectomy is the standard treatment for localised muscle invasive bladder cancer (MIBC). We offer a bladder-sparing treatment with TURB +/- Chemotherapy+Radiotherapy to selected patients as an alternative.
MATERIAL AND METHODS: We analyze, retrospectively, 30 patients diagnosed with MIBC from March 1991 to October 2010. The mean age was 62.7 years (51-74). All patients were candidates for a curative treatment, and underwent strict selection criteria: T2 stage, primary tumor, solitary lesion smaller than 5cm with a macroscopic disease-free status after TURB, negative random biopsy without hydronephrosis. Staging CT evaluation was normal. Restaging TURB or tumor bed biopsy showed a disease-free status or microscopic muscle invasion. 14 patients underwent TURB alone, 13 TURB+Chemotherapy and 3 TURB+Chemotherapy+Radiotherapy.
RESULTS: The mean follow up was 88.7 months (19-220). 14 patients remained disease free (46.6%), 10 had recurrent non-muscle invasive bladder cancer (33%). 81.3% complete clinical response. 71% bladder preserved at 5-years. Overall, 5-years survival rate was 79% and 85% cancer-specific survival rate.
CONCLUSIONS: Although radical cystectomy is the standard treatment for localised MIBC, in strictly selected cases, bladder-sparing treatment offers an alternative with good long term results.
Written by:
Lendínez-Cano G, Rico-López J, Moreno S, Fernández Parra E, González-Almeida C, Camacho Martínez E. Are you the author?
Servicio de Urología, Hospital Universitario Nuestra Señora de Valme, Sevilla, España.
Reference: Actas Urol Esp. 2013 Jun 19. pii: S0210-4806(13)00158-7.
doi: 10.1016/j.acuro.2013.03.004
PubMed Abstract
PMID: 23790610
Article in English, Spanish.
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