Browse by author
Lookup NU author(s): Dr James Roberts
Full text for this publication is not currently held within this repository. Alternative links are provided below where available.
Objective To evaluate the treatment of patients with muscle-invasive bladder cancer (T2-T-4a) by radical transurethral resection (TUR) and cisplatin-methotrexate systemic chemotherapy. Patients and methods Fifty patients with transitional cell carcinoma (TCC) of the bladder (nine T2, 36 T3 and eve T4a) were treated by 'complete' TUR of the bladder tumour followed by 2-6 cycles of cisplatin (70 mg/m(2)) and methotrexate (40mg/m(2)) chemotherapy. The median (range) tumour size was 3 (1-7 cm). In sh patients, attempted TUR at the dome of the bladder led to intraperitoneal perforation; the tumour was excised by partial cystectomy in these patients. The latest follow-up results from 57 patients treated by radical TUR and methotrexate alone, reported previously, are included. Results At the first evaluation cystoscopy immediately after completing chemotherapy. 38 patients were tumour-free, eight had persistent muscle-invasive TCC and four had Ta, T1 + CIS disease. With an overall median follow-up of 47 months, 10 additional patients relapsed with muscle-invasive carcinoma in the bladder after a median interval of 15.6 months: three patients developed Ta, T1 tumours, three Ta, T1 + CIS, and six CIS only, Six of the 10 recurrent invasive tumours were at the same site, but four were at a different site in the bladder. Although during followup 12 patients developed superficial recurrence that required endoscopic treatment, the bladder was preserved (free of muscle-invasive cancer) in 37 of 50 patients. In 30 of these 37, this was achieved with no need for salvage radiotherapy or cystectomy. Sh patients died from metastatic TCC with no tumour in the bladder, Conclusion In this selected group of patients, muscle-invasive bladder cancer was controlled by TUR and systemic chemotherapy, preserving normal bladder function in 60% of patients without apparently comprising overall survival.
Author(s): Tomas DH, Roberts JT, Hall RR, Reading J
Publication type: Article
Publication status: Published
Journal: BJU International
Year: 1999
Volume: 83
Issue: 4
Pages: 432-437
Print publication date: 01/03/1999
ISSN (print): 1464-4096
ISSN (electronic): 1464-410X
Publisher: Wiley-Blackwell Publishing Ltd.
