OUTCOME OF PATIENTS TREATED WITH BLADDER PRESERVATION PROTOCOL IN UROTHELIAL CARCINOMA OF URINARY BLADDER

Sameed Hussain; Abdus Samad Syed; Fouzia Abdus Samad

doi:10.51253/pafmj.v71i6.5847

Authors

Sameed Hussain Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Abdus Samad Syed Combined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Fouzia Abdus Samad Fauji Foundation Hospital, Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v71i6.5847

Keywords:

Bladder preservation, Concurrent chemoradiotherapy, Organ preservation, Radical cystectomy, Urinary bladder carcinoma

Abstract

Objective: To explore trimodality treatment with neoadjuvant chemotherapy followed by concurrent chemoradiotherapy as an alternative approach to neoadjuvant chemotherapy followed by radical cystectomy, for the treatment of non-metastatic muscle invasive bladder carcinoma.

Study Design: Retrospective observational study.

Place and Duration of Study: Combined Military Hospital Rawalpindi Pakistan, from 2006 and 2015.

Methodology: A total of 122 patients were evaluated in a retrospective manner. Primary endpoint was overall survival. Patients received four courses of neoadjuvant chemotherapy followed by radical concurrent chemoradiotherapy with Cisplatin as radiation sensitizer.

Result: 5-year overall survival was 80 (66%) in this population and a complete response following completion of treatment was seen in 93 (76.3%) patients. Subset analysis showed markedly increased 5-year overall survival of around 104 (85%) in patients having complete response after neoadjuvant chemotherapy.

Conclusion: The study concludes that bladder preservation is an acceptable alternative to radical cystectomy in selected population especially among those who had a complete response to the initial four courses of chemotherapy.