Neoadjuvant chemotherapy and bladder-sparing surgery for invasive bladder cancer: Ten-year outcome
Neoadjuvant chemotherapy and bladder-sparing surgery for invasive bladder cancer: Ten-year outcome
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DOI：
10.1200/jco.1998.16.4.1298
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发表时间：
1998-04-01
影响因子：
45.3
通讯作者：
Scher, HI
中科院分区：
文献类型：
--
作者：
Herr, HW;Bajorin, DF;Scher, HI
目的：评估对甲氨蝶呤、长春碱、阿霉素和顺铂 (MVAC) 联合化疗以及膀胱保留手术完全缓解的侵袭性（T2-3N0M0，根据肿瘤、淋巴结、转移系统分期）膀胱癌患者 IO 年结果。患者和方法：在接受新辅助 MVAC 的 111 名手术候选人中，60 名 (54%) 获得了完整的临床结果对原发肿瘤部位经尿道切除术 (TUR) 的反应 (TO)，其中 28 人要求单独进行 TUR 随访，15 人接受部分膀胱切除术，17 人选择根治性膀胱切除术。对患者进行中位随访时间为 10 年（范围为 8 至 13 年）。 结果：在 43 例接受膀胱保留手术的患者中，32 例（74%）存活，其中 25 例（58%）膀胱功能完整，24 例（56%）在 5 至 96 个月内出现膀胱肿瘤复发，其中 13 例（30%）为侵袭性，11 例为浅表性。 (26%)，13 例患者需要进行挽救性膀胱切除术，其中 6 例死亡，其中 4 例 (9%) 死于新的浸润性肿瘤，在 17 例接受根治性膀胱切除术的患者中，11 例 (65%) 存活，结论：新辅助 MVAC 化疗后达到 TO 状态的大多数浸润性膀胱肿瘤患者通过膀胱保留手术保留膀胱长达 10 年，膀胱仍然面临新的浸润性肿瘤的风险，膀胱切除术可以挽救大多数（但不是全部）复发患者。 (C) 1998 年美国临床肿瘤学会。
Purpose: To evaluate the IO-year outcome of patients with invasive (T2-3N0M0, staged according to the tumor, node, metastasis system) bladder cancer who responded completely to a combination of methotrexate, vinblastine, adriamycin, and cisplatin (MVAC) chemotherapy followed by bladder-sparing surgery,Patients and Methods: Of 111 surgical candidates who received neoadjuvant MVAC, 60 (54%) achieved a complete clinical response (TO) on transurethral resection (TUR) of the primary tumor site, Of these, 28 requested follow-up with TUR alone, 15 had a partial cystectomy, and 17 elected a radical cystectomy. The patients were followed up for a median of 10 years (range, 8 to 13 years).Results: Of 43 patients who had bladder-sparing surgery, 32 (74%) are alive, which includes 25 (58%) with an intact functioning bladder, Twenty-four patients (56%) developed bladder tumor recurrences from 5 to 96 months, which were invasive in 13 (30%) and superficial in 11 (26%), Thirteen patients required a salvage cystectomy, of whom 6 died, which includes 4 (9%) from a new invasive neoplasm, Of the 17 patients who had radical cystectomy, 11 (65%) are alive,Conclusion: The majority of patients with invasive bladder tumors who achieve TO status after neoadjuvant MVAC chemotherapy preserve their bladders for up to 10 years with bladder-sparing surgery, The bladder remains at risk for new invasive tumors, Cystectomy salvages the majority, but not all, of relapsing patients. (C) 1998 by American Society of Clinical Oncology.