title: Outcome of urinary bladder cancer after combined therapies.
abstract: Rationale:Urinary bladder cancer is the fourth most common cancer in men and the eighth in women, being an important public health issue.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:The distribution of the stage disease 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). 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 27 months.Discussion:Despite the combined therapy approaches, urinary bladder carcinoma remains an aggressive disease, with a high relapse rate. Earlier diagnosis, aggressive radical surgery in 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; D003131:Combined Modality Therapy; D015653:Cystectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*
keywords: bladder cancer; chemotherapy; incidence; radiotherapy; surgery