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Super-selective transcatheter vesical arterial chemoembolization with drug-loaded beads for muscle-invasive bladder cancer with hematuria

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

This retrospective study aimed to evaluate the clinical safety and efficacy of super-selective transcatheter vesical arterial chemoembolization with epirubicin-loaded CalliSpheres® beads (DEB-TACE) for treating muscle-invasive bladder cancer with hematuria.

Methods

We reviewed the retrospective records of 20 muscle-invasive bladder cancer patients with hematuria who were treated with super-selective transcatheter vesical arterial by oxaliplatin and 100–300-μm CalliSpheres loaded with epirubicin. The primary outcomes were the technical and clinical success rates. The secondary outcomes were complications, treatment responses, quality of life (QOL), median overall survival, and 1- and 2-year survival rates. QOL was routinely assessed by nurses at admission and during telephone follow-up 4 weeks after discharge.

Results

The technical success rate was 80.0% (16/20). Bleeding was controlled after the first embolization in 18/20 patients and after re-embolization within 7 days of the first embolization in the remaining two patients. The clinical success rate was 90% (18/20). After 4 weeks of follow-up, the mean hematocrit and hemoglobin levels improved significantly (P < 0.05). Four patients (20.0%) showed hematuria recurrence during a 4–8-month follow-up period. There were no severe complications, such as necrosis of the bladder, genitals, perineal skin, or procedure-related deaths. The complete response, partial response, stable disease, and progressive disease frequencies were 5.0%, 55.0%, 25.0%, and 15.0%, respectively, resulting in an objective response rate of 60.0% and a disease control rate of 85.0% after 1 month. 4 weeks after embolization, QOL was significantly higher than that pre-operation, except for social/family status (P < 0.05). The median overall survival was 18.5 months, and the 1- and 2-year survival rates were 75.0% and 46.7%, respectively.

Conclusion

DEB-TACE is safe and effective for treating muscle-invasive bladder cancer with hematuria, preserving bladder function and improving the QOL.

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Funding

This study was supported by the Launch Fund of Fujian Medical University (Grant No.: 2019QH1164) and General project of Fujian Natural Science Foundation (Grant No.: 2020J011096).

Author information

Author notes

  1. Yanfeng Zhou and Jingyi Chen have contributed equally to this work.

Authors and Affiliations

  1. Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China

    Yanfeng Zhou, Yi Tang, Shaojie Wu, Senlin Cai & Zhuting Fang

  2. Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China

    Yanfeng Zhou, Yi Tang, Shaojie Wu, Senlin Cai & Zhuting Fang

  3. The School of Nursing, Fujian Medical University, Fuzhou, China

    Jingyi Chen

  4. Department of Urology, Fujian Provincial Hospital, Fuzhou, China

    Pingzhou Chen

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  1. Yanfeng Zhou
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Contributions

All authors contributed to the study’s conception and design. YZ and JC performed material preparation, data collection, data analysis, and drafting the article. YZ and JC have contributed equally to this work. Pingzhou Chen performed management of the patients and data collection. YT, SW, and SC provided critical revision of the manuscript. ZF performed project administration and supervision. YZ and JC wrote the first draft of the manuscript, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Zhuting Fang.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was conducted in accordance with the provisions of the Declaration of Helsinki and was approved by the institutional review board of Fujian Provincial Hospital, Fuzhou, China. The requirement for written informed consent was waived owing to the study’s retrospective nature.

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Zhou, Y., Chen, J., Chen, P. et al. Super-selective transcatheter vesical arterial chemoembolization with drug-loaded beads for muscle-invasive bladder cancer with hematuria. Abdom Radiol 48, 780–786 (2023). https://doi.org/10.1007/s00261-022-03748-2

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