title: [Neoadjuvant chemotherapy in muscular invasive bladder cancer: Complications and consequences with cystectomy].
abstract: BACKGROUND
  The fear of the deterioration of the patient's condition related to the toxicity of neoadjuvant chemotherapy is a barrier to its development. This multicenter retrospective study aims to present the secondary effects of neoadjuvant chemotherapy and its impact on the achievement of cystectomy.
  
  
  METHODS
  Patients with urothelial carcinoma classified cT2 to cT4a N0M0 were included. Chemotherapy with 6 cycles of MVAC (methotrexate, vinblastine, adriamycin, and cisplatin) followed by a cysto-prostatectomy or anterior pelvectomy was scheduled.
  
  
  RESULTS
  A total 32 patients were included. Six cycles of neoadjuvant chemotherapy were performed in all 11 patients. Shutdown causes were toxicity in 85% of cases. Cystectomy was performed in 86.6% of patients. Surgery was not performed in 6 patients. The reasons were the alteration of the general condition in 2 cases, 2 patients had advanced cancers diagnosed intraoperatively, and 2 refused surgery. Complications of grades 3 and 4 according to the classification of Clavien and Dindo had occurred respectively in 15.3% and 11.5%.
  
  
  CONCLUSIONS
  This study reports results close to what is found in the literature on the effects of neoadjuvant chemotherapy on achieving cystectomy, but it has some limitations: the retrospective analysis of data on surgery and the lack of control group. In addition, the short follow-up does not yet allow to know the long-term oncological results.
  
  
  CONCLUSIONS
  This study supports the fact that the toxicity of neoadjuvant chemotherapy does not seem to cause a significant risk of non-completion of cystectomy.
  
  
  METHODS
  4.
authors.affiliation: Service d'urologie, hôpital Saint-Louis, 75011 Paris, France. Electronic address: steevebenadiba@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Benadiba
authors.affiliation: Service d'oncologie médicale, hôpital Saint-Louis, 75011 Paris, France.
authors.forename: H
authors.initials: H
authors.lastname: Gauthier
authors.affiliation: Service d'urologie, hôpital Saint-Louis, 75011 Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Ploussard
authors.affiliation: Service d'urologie, hôpital Saint-Louis, 75011 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Mongiat-Artus
authors.affiliation: Service d'urologie, hôpital Saint-Louis, 75011 Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Froger
authors.affiliation: Service d'urologie, hôpital Saint-Louis, 75011 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Basset
authors.affiliation: Service d'urologie, hôpital Saint-Louis, 75011 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Pashootan
authors.affiliation: Service d'urologie, centre hospitalier, 77100 Meaux, France.
authors.forename: E
authors.initials: E
authors.lastname: Chartier
authors.affiliation: Cabinet d'urologie, 77100 Mareuil-les-Meaux, France.
authors.forename: D
authors.initials: D
authors.lastname: Dadoun
authors.affiliation: Cabinet d'urologie, 77100 Mareuil-les-Meaux, France.
authors.forename: F
authors.initials: F
authors.lastname: Jacob
authors.affiliation: Service d'urologie, hôpital Bichat, 75018 Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Ravery
authors.affiliation: Cabinet d'urologie, 77100 Mareuil-les-Meaux, France.
authors.forename: S
authors.initials: S
authors.lastname: Culine
authors.affiliation: Service d'urologie, hôpital Saint-Louis, 75011 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Desgrandchamps
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D015653:Cystectomy / Q000706:statistics & numerical data*; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D011183:Postoperative Complications; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000628:therapy*; D014747:Vinblastine / Q000627:therapeutic use
chemical_list: D014747:Vinblastine; D004317:Doxorubicin; D002945:Cisplatin; D008727:Methotrexate
keywords: Cancer de vessie envahissant le muscle; Chimiothérapie néoadjuvante; Cystectomie; Cystectomy; Muscle-invasive bladder cancer; Neoadjuvant chemotherapy