title: Outcome of urinary bladder cancer after combined therapies.
abstract: BACKGROUND
  Urinary bladder cancer is the fourth most common cancer in men and the eighth in women, being an important public health issue.
  
  
  OBJECTIVE
  to assess the outcome of patients with urinary bladder cancer treated in an oncologic center.
  
  
  METHODS
  Medical files of 155 patients (132M/ 23F) with urinary bladder cancer treated between 2006 and 2012 were retrospectively analyzed. The median age at diagnosis was 65 years (range: 19-85 years). Disease free survival (DFS) for patients with complete tumor resection receiving adjuvant treatment and progression free survival (PFS) for patients with post-operative residual disease was estimated.
  
  
  RESULTS
  Stage disease's distribution was: 50 patients (32.2%) stage II, 47 (30.3%) stage III, 58 (37.4%) stage IV. Radical cystectomy was performed in 56 patients (36.1%), while 99 patients (63.9%) underwent repeated transurethral resection of the urinary bladder tumor (TURBT). The postoperative treatment included multimodal therapy in 47 patients (30.3%) (chemotherapy and external beam radiation), external beam radiation alone in 57 patients (36.8%) and chemotherapy alone (methotrexate, vinblastine, doxorubicin, and cisplatin-MVAC or gemcitabine + platinum) in 51 patients (32.9%). After a median follow-up of 31 months (range: 3-79 months), 51 patients (32.9%) presented local recurrence, 32 patients (21%) distant recurrence (metastases), 10 patients (6.4%) both local and distant recurrence, and 62 patients (40%) were free of disease. The median duration until progression was of 27 months.
  
  
  CONCLUSIONS
  Despite combined therapy approaches, urinary bladder carcinoma remains an aggressive disease, with high relapse rate. Earlier diagnosis and an aggressive radical surgery with the intention to cure (cystectomy), and adjuvant multimodal treatment (radiotherapy and chemotherapy) are needed for survival improvement.
authors.affiliation: Al. Trestioreanu" Institute of Oncology, Bucharest, Romania; "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: R M
authors.initials: RM
authors.lastname: Anghel
authors.affiliation: Al. Trestioreanu" Institute of Oncology, Bucharest, Romania; "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: L N
authors.initials: LN
authors.lastname: Gales
authors.affiliation: Al. Trestioreanu" Institute of Oncology, Bucharest, Romania; "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: O G
authors.initials: OG
authors.lastname: Trifanescu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002295:Carcinoma, Transitional Cell / Q000628:therapy*; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D015653:Cystectomy; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000628:therapy*; D014747:Vinblastine / Q000627:therapeutic use; D055815:Young Adult; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D014747:Vinblastine; D004317:Doxorubicin; D002945:Cisplatin; D008727:Methotrexate; D000093542:Gemcitabine
keywords: bladder cancer; chemotherapy; radiotherapy; surgery