J 2018

Clinically node-positive bladder cancer: oncological results of induction chemotherapy and consolidative surgery

STANÍK, Michal, Alexandr POPRACH, D. MACIK, I. CAPAK, Denisa KREJČÍ et. al.

Basic information

Original name

Clinically node-positive bladder cancer: oncological results of induction chemotherapy and consolidative surgery

Authors

STANÍK, Michal (703 Slovakia, guarantor), Alexandr POPRACH (203 Czech Republic), D. MACIK (203 Czech Republic), I. CAPAK (203 Czech Republic), Denisa KREJČÍ (203 Czech Republic, belonging to the institution), N. MARECKOVA (203 Czech Republic), Radek LAKOMÝ (203 Czech Republic), Jiří JARKOVSKÝ (203 Czech Republic, belonging to the institution) and Jan DOLEŽEL (203 Czech Republic)

Edition

Neoplasma, Bratislava, Slovenská akademie vied, 2018, 0028-2685

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30204 Oncology

Country of publisher

Slovakia

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 1.771

RIV identification code

RIV/00216224:14110/18:00104048

Organization unit

Faculty of Medicine

DOI

UT WoS

000435149800016

Keywords in English

urinary bladder neoplasms; lymphadenopathy; combined modality therapy; induction chemotherapy; cystectomy

Tags

Tags

International impact, Reviewed
Změněno: 9/2/2019 21:39, Soňa Böhmová

Abstract

V originále

Patients with clinically node-positive bladder cancer have a poor prognosis, with many receiving only palliative chemotherapy. We evaluated oncological results in bladder cancer patients with clinically regional and supraregional lymphadenopathy treated with induction chemotherapy (IC) and consolidative cystectomy. Twenty-five patients with clinically node-positive bladder cancer (including pelvic and retroperitoneal nodes) were treated with 2-4 cycles of IC followed by consolidative cystectomy between 2010 and 2016. Pathologic complete response (pCR) was defined as no residual tumor in the final specimen (ypT0N0). The 3-year cancer-specific (CSS) and recurrence-free survival (RFS) for the whole cohort were 52% and 39%, respectively. The 3-year RFS differed according to volume of nodal metastases, the rates were 56% for minimal nodal disease (cN1) versus 33% for cN2-3 and 0% for cM1 disease (p<0.001). pCR was seen in 7 (28%) patients; 50% in cN1 versus 13% in cN3-M1. pCR associated with 3-year CSS of 80% versus 45% in patients with persistent disease aft er IC. In conclusion, a multimodal approach to patients with clinically node-positive bladder cancer, consisting of IC followed by consolidative surgery, may achieve long-term survival in selected patients. Better results may be expected in patients with initially minimal nodal burden and complete pathologic response to chemotherapy. Further studies are warranted to improve patient selection for consolidative surgery, especially with supra-regional metastases.