title: Outcomes of trimodality approach in the management of T2N0M0 bladder cancer.
abstract: OBJECTIVE
  The main objective of this study is to evaluate outcomes of bladder preservation treatment for patients with muscle-invasive bladder cancer.
  
  
  METHODS
  38 patients with histologically proven muscle-invasive bladder cancer treated at our department between January 2008 and December 2013 were analyzed retrospectively. Age, gender, pathology, stage, 3-year overall survival, 3-year disease-free survival, radiotherapy (RT) dose, genitourinary and gastrointestinal toxicity scores and response evaluation of the patients were recorded. 3-year overall survival and 3-year disease-free survivals were calculated by Kaplan-Meier method along with the analysis of gender, pathology, stage and therapy response of the study group.
  
  
  RESULTS
  33 patients (86.8%) were managed with concomitant chemoradiotherapy whereas 5 patients (13.2%) received only radiation therapy due to renal insufficency and comorbid diseases. 6 (15.8%) out of 38 patients had partial response (PR) and remaining 32 (84.2%) patients experienced complete response (CR). The PR group underwent salvage cystectomy and CR group had been followed-up after radical radiotherapy. Mean age of the group was 70.9 (range 45-90) years. 26 of all patients were male (68.4%) and 12 were female (31.6%). Mean follow-up time after completion of radiotherapy was 24.7 months (range 12-40). Mean RT dose was 64 Gy (range 60-66). 3-year overall survival was 64% and 3-year disease free survival was 73%.
  
  
  CONCLUSIONS
  Bladder preserving approach is an alternative definitive therapy solution to radical cystectomy in the treatment of muscle-invasive bladder cancer with less morbidity, preserved natural bladder, and high quality of life.
authors.affiliation: Department of Radiation Oncology, Gulhane Military Medical Academy, Ankara - Turkey.
authors.forename: Bora
authors.initials: B
authors.lastname: Uysal
authors.forename: Murat
authors.initials: M
authors.lastname: Beyzadeoglu
authors.forename: Selcuk
authors.initials: S
authors.lastname: Demiral
authors.forename: Hakan
authors.initials: H
authors.lastname: Gamsiz
authors.forename: Ferrat
authors.initials: F
authors.lastname: Dincoglan
authors.forename: Omer
authors.initials: O
authors.lastname: Sager
authors.forename: Mustafa
authors.initials: M
authors.lastname: Akin
authors.forename: Mustafa Alparslan
authors.initials: MA
authors.lastname: Babayigit
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D015653:Cystectomy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D041741:Lower Gastrointestinal Tract / Q000187:drug effects / Q000528:radiation effects; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011788:Quality of Life; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000628:therapy*; D014566:Urogenital System / Q000187:drug effects / Q000528:radiation effects