title: [Stage T4 bladder cancer. Impact of neoadjuvant chemotherapy on T4b tumors].
abstract: The present article studied the biological behaviour of T4a versus T4b tumors. Of 29 patients with T4a tumors, 24 were treated by radical cystectomy and 5 were treated by diversion alone on detecting pathologic gross adenopathies at laparotomy. Of these 10/28 (35.7%) are alive and tumor-free. Of 11 patients with T4b tumors, 7 were initially treated with systemic chemotherapy (6 M-VAC and 1 5-FU + ADM) which achieved a clinical response in 4; 1 (14.2%) was RCc. Posteriorly, all these patients underwent radical cystectomy that revealed 2 had RPp and 2 had tumor progression (N+), accounting for an RPp rate of 28.5% and tumor progression of 71.5%. Overall, with a mean follow-up of 13.3 months, only 1 patient is tumor free. The foregoing findings show the different behaviour of these two groups of patients with an incidence of tumor positive adenopathies of 48.2% and 72.7% and tumor-free survival of 35.7% and 9.0% for patients with T4a and T4b, respectively.
authors.affiliation: Servicio de Urología, Instituto Valenciano de Oncología (IVO), España.
authors.forename: E
authors.initials: E
authors.lastname: Solsona
authors.forename: I
authors.initials: I
authors.lastname: Iborra
authors.forename: J V
authors.initials: JV
authors.lastname: Ricós
authors.forename: J L
authors.initials: JL
authors.lastname: Monrós
authors.forename: R
authors.initials: R
authors.lastname: Dumont
authors.forename: V
authors.initials: V
authors.lastname: Guillem
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D014547:Urinary Diversion; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D014747:Vinblastine; D004317:Doxorubicin; D002945:Cisplatin; D005472:Fluorouracil; D008727:Methotrexate
vernacular_title: Carcinoma vesical estadio T4. Impacto de la quimioterapia neoadyuvante en tumores T4b.