title: [The role of M-VAC polychemotherapy in the treatment of advanced urothelial carcinoma of the bladder].
abstract: Over the last seven years, M-VAC combination chemotherapy has been used for: the treatment of transitional cell carcinoma with metastases (palliative indication) or to reduce operable T4a tumours (inductive, initial or preliminary indication), or before or after t for bladder cancers (neoadjuvant and adjuvant indications). The authors present their experience of 17 cases of stage T4a transitional cell carcinoma transformed into an operable stage by M-VAC. Those patients with regression of the tumour to a non-invasive stage at operation (patients with a good response) had a good prognosis. In contrast those patients with residual invasive tumour all died from their disease. A prospective comparative study was performed between total cystectomy alone and cystectomy completed by adjuvant M-VAC in patients with a worrying histology. This study was based on 49 cases up until December 1990. A significant improvement in the prognosis was observed in patients receiving adjuvant M-VAC. The recurrence-free survival was considerably prolonged in this second group (study suspended in November 1992). When metastases developed, palliative M-VAC only rarely prolonged survival.
authors.affiliation: Clinique Urologique, Université Johannes Gutenberg, Mainz.
authors.forename: M
authors.initials: M
authors.lastname: Stöckle
authors.forename: W
authors.initials: W
authors.lastname: Meyenburg
authors.forename: S
authors.initials: S
authors.lastname: Wellek
authors.forename: G
authors.initials: G
authors.lastname: Voges
authors.forename: U
authors.initials: U
authors.lastname: Gertenbach
authors.forename: J W
authors.initials: JW
authors.lastname: Thüroff
authors.forename: C
authors.initials: C
authors.lastname: Huber
authors.forename: R
authors.initials: R
authors.lastname: Hohenfellner
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002278:Carcinoma in Situ / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D015653:Cystectomy; D004317:Doxorubicin / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010166:Palliative Care; D012074:Remission Induction; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D015251:Epirubicin; D014747:Vinblastine; D004317:Doxorubicin; D002945:Cisplatin; D008727:Methotrexate