Summary
We have treated advanced transitional-cell carcinoma of the urothelial tract with methotrexate, vinblastine, Adriamycin, and cisplatin (M-VAC) chemotherapy since July of 1985. We analyzed the effect of that chemotherapy in 26 patients with advanced urothelial cancer who were treated in our hospital and followed up. They were divided into two groups. Group 1 consisted of 15 patients with distant metastases. In all, 11 of them received M-VAC as adjuvant chemotherapy for metastatic lesions after surgical removal of the primary lesion, and the remaining 4 patients were not operable since they had very advanced-stage tumors; they received only M-VAC chemotherapy. Group 2 contained 11 patients who received M-VAC neo-adjuvant chemotherapy. In group 1, the overall response rate was 57.1% and the mean duration of response was 12.6 months. In the 11 patients who had received M-VAC as adjuvant therapy after surgical removal of the primary tumor, the mean duration of response was 14.1 months. After M-VAC chemotherapy, six patients underwent surgical resection of metastatic lesions and restaging was done pathologically in these cases. The clinical response coincided with the pathological response in all six cases. In group 2,5 of 11 patients experienced histological downstaging of the resected bladder. M-VAC chemotherapy combined with surgical resection of residual tumors has proved to be an effective option against advanced urothelial cancer.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Batata MA, Whitmore WF, Chu FC, Hilaris BS, Unal A, Chung S (1980) Patterns of recurrence in bladder cancer treated by irradiation and/or cystectomy. Int J Radiat Oncol Biol Phys 6: 155
Bloom HJG, Hendry WF, Wallace DM, Skeet RG (1982) Treatment of T3 bladder cancer: controlled trial preoperative radiotherapy and radical cystectomy versus radical radiotherapy. Br J Urol 54: 136
Koyama Y, Saitoh T (1980) Standards for clinical effective evaluation of cancer chemotherapy. Report of the study supported by the Grant-in-Aid from the Ministry of the Health and Welfare in 1977, 1978 and 1979. Ministry of Health and Welfare, Tokyo, p 1
McCullough DL, Cooper RM, Yeaman LD, Loomer L, Woodruff RD, Boyce WH, Harrison LH, Assimos DG, Lynch DF (1989) Neoadjuvant treatment of stages T2 to T4 bladder cancer with cisplatinum, cyclophosphamide and doxorubicin. J Urol 141: 849
Miller LS, Johnson DE (1973) Megavoltage irradiation for bladder cancer: alone, postoperative, or preoperative. Proceedings of the 7th National Cancer Conference, Houston, Texas, p 771
Prout GR (1976) The surgical management of bladder carcinoma. Urol Clin North Am 3: 149
Scher HI, Yagoda A, Herr HW, Sternberg CN, Bosl G, Morse MJ, Sogani PC, Watson RC, Dershaw DD, Reuter V, Geller N, Hollander PS, Vaughan ED, Whitmore WF, Fair WR (1988) Neoadjuvant M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) effect on the primary bladder lesion. J Urol 139: 470
Scher HI, Yagoda A, Herr HW, Sternberg CN, Morse MJ, Sogani PC, Watson RC, Reuter V, Whitmore WF, Fair WR (1988) Neoadjuvant M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) for extravesical urinary tract tumors. J Urol 139: 475
Shimosato Y, Oboshi S, Baba K (1971) Histological evaluation of effects of radiotherapy and chemotherapy for carcinoma. Jpn J Clin Oncol 1: 19
Sternberg CN, Yagoda A, Scher HI, Watson RC, Ahmed T, Weiselberg LR, Geller N, Hollander PS, Herr HW, Sogani PC, Morse MJ, Whitmore WF (1985) Preliminary results of M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) for transitional cell carcinoma of the urothelium. J Urol 133: 403
Sternberg CN, Yagoda A, Scher HI, Watson RC, Herr HW, Morse MJ, Sogani PC, Vaughan ED, Bander N, Weiselberg LR, Geller N, Hollander PS, Lipperman R, Fair WR, Whitmore WF (1988) M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) for advanced transitional cell carcinoma of the urothelium. J Urol 139: 461
Whitmore WF (1979) Management of bladder cancer. Curr Probl Cancer 4: 48
Whitmore WF, Yagoda A (1989) Chemotherapy in the management of bladder tumours. Drugs 38: 301
Yagoda A (1983) Chemotherapy for advanced urothelial cancer. Semin Urol 1: 60
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ogawa, T., Gotoh, A., Takenaka, A. et al. Clinical and pathological evaluations of methotrexate, vinblastine, Adriamycin and cisplatin chemotherapy for advanced urothelial cancers. Cancer Chemother. Pharmacol. 30 (Suppl 1), S66–S71 (1992). https://doi.org/10.1007/BF00686946
Issue Date:
DOI: https://doi.org/10.1007/BF00686946