[Infiltrating transitional carcinoma of the bladder. Preoperative or neoadjuvant chemotherapy. Our experience with 38 patients with long-term follow-up].
We reviewed the clinical records of 37 patients who had been treated with neoadjuvant chemotherapy + radical cystectomy and bilateral lymphadenectomy. The patients were followed until they died and the survivors have a follow-up of 43 to 68 months. There were 28 deaths: 20 patients died within 24 months following treatment and 6 died after two years. Five patients were not submitted to surgery due to rapid tumor progression while they were receiving cytostatic therapy. Bladder removal was ruled out in 5 patients with important loco-regional spread demonstrated on laparotomy. The bladder was preserved in 12 patients. Eight patients had cRC: 1 died from causes unrelated to the disease; 1 was lost to follow-up at 16 months, with no evidence of bladder cancer or metastasis; 3 developed distant metastasis, and 3 are alive and tumor-free. One pCR died with evidence of metastasis; 1 cRP required radical cystectomy and died from metastasis. Of the patients classified as sRC, 1 subsequently underwent radical cystectomy and is disease-free and the other died from metastasis. Fifteen patients underwent radical cystectomy: 3 are alive and tumor-free, 2 were lost to follow-up and 10 patients died (3 from causes unrelated to the disease and 7 died from the disease). Lymph node invasion was observed in 54%. Metastasis was observed in 57.3% and local recurrence in 17.3%. The preoperative chemotherapy schedule under study did not prolong the metastasis-free period in this group of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Servicio de Urología, Hospital Ramón y Cajal, Madrid, España.
A
A
Escudero Barrilero
E
E
Fernández Fernández
C
C
Crespo Maffieu
D002295:Carcinoma, Transitional Cell / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D015653:Cystectomy; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery*
Carcinoma transicional infiltrante de vejiga. Quimioterapia preoperatoria o neoadyuvante. Nuestra experiencia con 38 enfermos con seguimiento prolongado.