title: [EFFICACY OF NEOADJUVANT GEMCITABINE AND CISPLATIN IN THE MANAGEMENT OF MUSCLE-INVASIVE UROTHELIAL CARCINOMA OF THE BLADDER].
abstract: OBJECTIVE
  We investigated the efficacy of neoadjuvant chemotherapy with gemcitabine and cisplatin (GC) in patients with muscle-invasive bladder cancer.
  
  
  METHODS
  This was a retrospective analysis of 14 patients who received neoadjuvant GC before radical cystectomy for clinical stage T2-4N0-3M0 bladder cancer. The primary outcome was pT0 rate and no residual muscle-invasion (≤ pT1) at cystectomy.
  
  
  RESULTS
  Before chemotherapy, clinical stage T2 was in 8 (57%), T3 in 6 (43%) and N + in 3 (21%). Relative dose intensity was 75% for gemcitabine and 91% for cisplatin. At cystectomy, pT0 was observed in 4 (29%) and ≤ pT1 in 10 (71%). Regarding lymph node metastasis, 2 with N1 had pN0 and pN1, respectively, and 1 with N3 did pN1. Grade 3 or 4 anemia, thrombocytopenia, neutropenia, and febrile neutropenia were observed in 3 (21%), 9 (64%), 9 (64%) and 1 (7%), respectively. Three patients died of bladder cancer at median follow-up of 33 months. The 4-year overall survival rate in patients with pT0 was 100% compared to 47% in those with residual diseases (P = 0.153).
  
  
  CONCLUSIONS
  We showed the proportion of pT0 at cystectomy to predict the effect of neoadjuvant GC. The results suggest that neoadjuvant GC is feasible for patients with muscle-invasive bladder cancer.
authors.forename: Kohei
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Shindo
authors.forename: Naoki
authors.initials: N
authors.lastname: Itoh
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology*; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D001743:Urinary Bladder / Q000473:pathology*; D014571:Urologic Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine