title: Retrospective analysis of the efficacy of two cycles of M-VAC neoadjuvant chemotherapy followed by radical cystectomy for muscle-invasive bladder cancer.
abstract: BACKGROUND
  Neoadjuvant chemotherapy before radical cystectomy for muscle-invasive bladder cancer is a commonly used treatment modality. However, in terms of chemotherapeutic regimens and the number of cycles of neoadjuvant chemotherapy, there is yet no international consensus, as various studies indicate the efficacy of several platinum-based combination chemotherapeutic regimens. We determined the efficacy of two cycles of neoadjuvant chemotherapy with methotrexate, vinblastine, adriamycin, and cisplatin followed by radical cystectomy.
  
  
  METHODS
  The study population included patients with clinical stage T2 - T4a, N0, M0 bladder cancer who underwent radical cystectomy. Clinical courses were compared between 27 patients treated with two cycles of M-VAC neoadjuvant chemotherapy and 25 treated with cystectomy alone.
  
  
  RESULTS
  The incidence of pT0 was 25.9% in the group treated with neoadjuvant chemotherapy. The probabilities of disease-free and cause-specific survival were significantly higher in patients treated with, than without neoadjuvant chemotherapy. On univariate Cox proportional hazards regression analysis for the patients treated with neoadjuvant chemotherapy, pathological stage and the pathological findings of venous involvement were significant prognostic factors.
  
  
  CONCLUSIONS
  The results of this retrospective study demonstrated the clinical effectiveness of two cycles of neoadjuvant M-VAC chemotherapy for muscle-invasive bladder cancer.
authors.affiliation: Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Takaramachi 13-1, Kanazawa, Ishikawa, Japan. yasukita@med.kanazawa-u.ac.jp.
authors.forename: Yasuhide
authors.initials: Y
authors.lastname: Kitagawa
authors.forename: Kouji
authors.initials: K
authors.lastname: Izumi
authors.forename: Sotaro
authors.initials: S
authors.lastname: Miwa
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kadono
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Konaka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Mizokami
authors.forename: Mikio
authors.initials: M
authors.lastname: Namiki
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D015653:Cystectomy; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D014747:Vinblastine / Q000627:therapeutic use
chemical_list: D014747:Vinblastine; D004317:Doxorubicin; D002945:Cisplatin; D008727:Methotrexate
keywords: MVAC chemotherapy; Muscle-invasive bladder cancer; neoadjuvant chemotherapy