Intra-arterial chemotherapy for muscle-invasive bladder cancer following transurethral resection

Urol Int. 2015;94(4):406-11. doi: 10.1159/000369301. Epub 2015 Feb 12.

Abstract

Purpose: To assess the efficacy of intra-arterial chemotherapy as a bladder-preservation treatment in patients with muscle-invasive bladder cancer (MIBC) following transurethral resection of bladder tumors (TURBT).

Materials and methods: From 2005 June to 2012 November, 46 patients diagnosed with MIBC (clinical stage T2-T3N0M0) underwent three courses of cisplatin-based intra-arterial chemotherapy as a remedial approach for bladder preservation after TURBT. All patients also received intravesical instillation of chemotherapy as a maintenance strategy.

Results: All 46 patients completed the treatment with minor complications. The median follow-up time was 34.5 months (range, 8-87 months). Thirty-two patients (69.6%) demonstrated complete response. The three-year and five-year overall survival was 70.65 and 61.23%, and the disease-specific survival over the same periods was 78.03 and 67.62%, respectively. During the entire follow-up period, more than 80% preserved their bladder.

Conclusions: Intra-arterial chemotherapy can be performed as a remedial treatment for MIBC patient following TURBT. Combined with TURBT, it offers an option for bladder preservation therapy on patients who are unable or unwilling to undergo radical cystectomy.

MeSH terms

  • Administration, Intravesical
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents / adverse effects
  • Chemotherapy, Adjuvant
  • Cisplatin / administration & dosage*
  • Cisplatin / adverse effects
  • Cystectomy / adverse effects
  • Cystectomy / methods*
  • Cystectomy / mortality
  • Disease Progression
  • Disease-Free Survival
  • Female
  • Humans
  • Infusions, Intra-Arterial
  • Kaplan-Meier Estimate
  • Maintenance Chemotherapy
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Organ Sparing Treatments / adverse effects
  • Organ Sparing Treatments / methods*
  • Organ Sparing Treatments / mortality
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Urinary Bladder Neoplasms / drug therapy*
  • Urinary Bladder Neoplasms / mortality
  • Urinary Bladder Neoplasms / pathology
  • Urinary Bladder Neoplasms / surgery*

Substances

  • Antineoplastic Agents
  • Cisplatin