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The role of adjuvant chemotherapy in patients with locally advanced (pT3, pT4a) and/or lymph node–positive bladder cancer

International Urology and Nephrology volume 42, pages 959–964 (2010)Cite this article

Abstract

Objective

To report the long-term follow up of patients with locally advanced bladder cancer treated with either adjuvant chemotherapy with gemcitabine/cisplatin (GC) or methotrexate, vinblastine, epirubicin, and cisplatin (MVEC) or no additional treatment after radical cystectomy, to examine various survival endpoints and factors associated with long-term survival.

Patients and methods

Seventy-eight patients undergoing radical cystectomy for pathologic stage T3, T4 or lymph node–positive (N+) bladder cancer were divided to observation group (46 patients) and adjuvant chemotherapy group (32 patients). Data were obtained for recurrence free (RFS) and overall survival (OS).

Results

One-, 2- and 5-year RFS rates were 74, 56.8 and 51.1% for chemotherapy arm, whereas these ratios were 50.6, 31 and 27.6% for control arm, respectively (P = 0.032). RFS rates were significantly better in patients with lymph node–negative disease than in those with positive lymph nodes for control arm (P = 0.007), but for the chemotherapy arm there was no statistical difference between patients with lymph node–negative and –positive disease (P = 0.28). Mean OS and RFS times were 31.03 and 28.4 months for chemotherapy arm, while they were 22.17 and 18.09 months for control arm, respectively (P = 0.142, P = 0.196). On multivariate analysis, lymph node metastasis and adjuvant chemotherapy remained significant independent prognostic factors for cancer-specific survival.

Conclusions

Bladder cancer is chemosensitive, and using adjuvant chemotherapy is likely to improve the outcome of local treatment and to decrease the rates of distant metastases.

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Affiliations

  1. Department of Urology, Kecioren Training and Research Hospital, Ankara, Turkey

    Berkan Reşorlu

  2. Faculty of Medicine, Department of Urology, University of Ankara, Ankara, Turkey

    Kadir Türkölmez, Sümer Baltacı, Çağatay Göğüş & Yaşar Bedük

  3. Faculty of Science, Department of Statistics, University of Hacettepe, Ankara, Turkey

    Gül Ergün

  4. Kardesler Koop. 182.cad, 175. Sok., No:14/8, PK: 06010, Kecioren, Ankara, Turkey

    Berkan Reşorlu

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  1. Berkan Reşorlu
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  2. Kadir Türkölmez
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  3. Gül Ergün
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  4. Sümer Baltacı
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  5. Çağatay Göğüş
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  6. Yaşar Bedük
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Correspondence to Berkan Reşorlu.

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Reşorlu, B., Türkölmez, K., Ergün, G. et al. The role of adjuvant chemotherapy in patients with locally advanced (pT3, pT4a) and/or lymph node–positive bladder cancer. Int Urol Nephrol 42, 959–964 (2010). https://doi.org/10.1007/s11255-010-9736-5

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  • DOI: https://doi.org/10.1007/s11255-010-9736-5

Keywords

  • Adjuvant chemotherapy
  • Bladder cancer
  • Cisplatin
  • Prognosis
  • Radical cystectomy