TUR and Adjuvant Intravesical Chemotherapy in T1G3 Bladder Tumors: Recurrence, Progression and Survival in 137 Selected Patients Followed Up to 20 Years
Autor: | Michele Pavone-Macaluso, Carlo Pavone, G. Daricello, Rosalinda Allegro, Vincenzo Serretta, G.B. Ingargiola |
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Přispěvatelé: | SERRETTA V, PAVONE C, INGARGIOLA GB, DARICELLO G, ALLEGRO R, PAVONE-MACALUSO M |
Rok vydání: | 2004 |
Předmět: |
Adult
medicine.medical_specialty Time Factors Urology Population Intravesical adjuvant chemotherapy Disease-Free Survival Settore MED/24 - Urologia T1G3 bladder cancer medicine Adjuvant therapy Humans education Survival rate Aged Neoplasm Staging Aged 80 and over Carcinoma Transitional Cell education.field_of_study Urinary bladder Bladder cancer business.industry Middle Aged medicine.disease Surgery Survival Rate medicine.anatomical_structure Urinary Bladder Neoplasms Chemotherapy Adjuvant Tumor progression Concomitant Disease Progression Urologic Surgical Procedures Neoplasm Recurrence Local business Conservative treatment Follow-Up Studies Epirubicin medicine.drug |
Zdroj: | European Urology. 45:730-736 |
ISSN: | 0302-2838 |
Popis: | OBJECTIVES: To evaluate a highly selected population of patients affected by T1G3 bladder transitional cell carcinoma (TCCB) treated by transurethral resection (TUR) and adjuvant intravesical chemotherapy. MATERIALS AND METHODS: Between January 1976 and April 1999, 137 patients with T1G3 TCCB were treated by TUR plus intravesical chemotherapy. Particularly, a sequential combination of mitomycin C (MMC) and epirubicin (EPI) was adopted in 91 patients (66.4%). The main exclusion criteria were concomitant or previous Tis, previous T1G3 TCCB, tumor size greater than 3 centimeters and number of tumors more than 3. TUR was repeated if a superficial tumor recurred. Patients went off study if Tis, recurrent T1G3 or invasive tumor were detected during treatment or thereafter. Adjuvant therapy, recurrence and progression were considered in multivariate analysis regarding recurrence, progression and survival respectively. RESULTS: Observation period was up to 240 months with a minimum of 2 years in 112 patients (82%). Seventy patients (51%) recurred. The recurring tumor was again a T1G3 in 22 (16%) patients. Thirteen patients (9.5%) progressed. The 5-year progression-free survival rate was 90%. Median progression-free survival was 149 months. Twenty-two patients (16%) died, 9 (6.6%) of whom due to bladder cancer. Median overall survival was 155 months. The 3- and 5-year disease-free overall survival rates were 89% and 80% respectively. Ten cystectomies (7.3%) were performed. In conclusion, 123 patients (90%) maintained their intact bladder with a mean disease-free overall survival of 104 months. The sequential combination of MMC and EPI adjuvant therapy resulted more effective to be than single drug chemotherapy on recurrence rate (p=0.0021) but had no impact upon progression (p=0.127) and specific survival (p=0.163). Progression (p |
Databáze: | OpenAIRE |
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