Efficacy of radical cystectomy plus adjuvant intraarterial chemotherapy with gemcitabine and cisplatin on locally advanced bladder cancer
Background Bladder cancer is the ninth most common cancer in the world; fewer than 15% of transitional-cell carcinoma patients survive 2 years if left untreated.Although radical cystectomy is the standard treatment of choice,much of them relapse and the necessity of adjuvant chemotherapy is still un...
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Veröffentlicht in: | Chinese medical journal 2014-04, Vol.127 (7), p.1249-1254 |
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description | Background Bladder cancer is the ninth most common cancer in the world; fewer than 15% of transitional-cell carcinoma patients survive 2 years if left untreated.Although radical cystectomy is the standard treatment of choice,much of them relapse and the necessity of adjuvant chemotherapy is still under debate.The aim of the study was to evaluate the efficacy of adjuvant intraarterial chemotherapy (IAC) with gemcitabine and cisplatin (GC) on locally advanced bladder cancer.Methods This is a retrospective study on 60 patients with locally advanced bladder carcinoma who underwent radical cystectomy between May 2000 and June 2011.Patients were studied in two groups based on IAC and followed up for up to 5 years.Results Among 60 patients,there were 25 patients who underwent IAC (GC) after radical cystectomy (the IAC group) and 35 patients who underwent radical cystectomy alone (the control group).Although not significant,the relapse rates were slightly reduced in the IAC group than in the control group.Patients with IAC had a reduction in mortality compared with patients without IAC over 5 years.Specifically,IAC significantly reduced about 82% of mortality within the first year (hazard ratio=0.18,95% Cl 0.03-0.97,P=-0.04).Additionally,IAC was well tolerated and safe.The most common adverse effect was transient myelosuppression (10/25,40%),which was resolved by various medical treatments.Conclusions Compared with radical cystectomy alone,radical cystectomy in combination with adjuvant IAC moderately but significantly reduces 1-year mortality.Our preliminary data showed only marginal benefit for the early survival.However,a randomized clinical study is needed to determine the long-term survival benefit. |
doi_str_mv | 10.3760/cma.j.issn.0366-6999.20131612 |
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Ltd. All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c367t-d014226d9e4c6dca98382853c89ff5c1d96323303e7589ae33e5b1b5888438663</citedby><cites>FETCH-LOGICAL-c367t-d014226d9e4c6dca98382853c89ff5c1d96323303e7589ae33e5b1b5888438663</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Uhttp://image.cqvip.com/vip1000/qk/85656X/85656X.jpg</thumbnail><link.rule.ids>314,776,780,860,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24709175$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jiang, Lijuan</creatorcontrib><creatorcontrib>Zhang, Zhiling</creatorcontrib><creatorcontrib>Dong, Pei</creatorcontrib><creatorcontrib>Li, Yonghong</creatorcontrib><creatorcontrib>Yao, Kai</creatorcontrib><creatorcontrib>Liu, Zhuowei</creatorcontrib><creatorcontrib>Han, Hui</creatorcontrib><creatorcontrib>Qin, Zike</creatorcontrib><creatorcontrib>Yao, Min</creatorcontrib><creatorcontrib>Zhou, Fangjian</creatorcontrib><title>Efficacy of radical cystectomy plus adjuvant intraarterial chemotherapy with gemcitabine and cisplatin on locally advanced bladder cancer</title><title>Chinese medical journal</title><addtitle>Chinese Medical Journal</addtitle><description>Background Bladder cancer is the ninth most common cancer in the world; fewer than 15% of transitional-cell carcinoma patients survive 2 years if left untreated.Although radical cystectomy is the standard treatment of choice,much of them relapse and the necessity of adjuvant chemotherapy is still under debate.The aim of the study was to evaluate the efficacy of adjuvant intraarterial chemotherapy (IAC) with gemcitabine and cisplatin (GC) on locally advanced bladder cancer.Methods This is a retrospective study on 60 patients with locally advanced bladder carcinoma who underwent radical cystectomy between May 2000 and June 2011.Patients were studied in two groups based on IAC and followed up for up to 5 years.Results Among 60 patients,there were 25 patients who underwent IAC (GC) after radical cystectomy (the IAC group) and 35 patients who underwent radical cystectomy alone (the control group).Although not significant,the relapse rates were slightly reduced in the IAC group than in the control group.Patients with IAC had a reduction in mortality compared with patients without IAC over 5 years.Specifically,IAC significantly reduced about 82% of mortality within the first year (hazard ratio=0.18,95% Cl 0.03-0.97,P=-0.04).Additionally,IAC was well tolerated and safe.The most common adverse effect was transient myelosuppression (10/25,40%),which was resolved by various medical treatments.Conclusions Compared with radical cystectomy alone,radical cystectomy in combination with adjuvant IAC moderately but significantly reduces 1-year mortality.Our preliminary data showed only marginal benefit for the early survival.However,a randomized clinical study is needed to determine the long-term survival benefit.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Cisplatin - therapeutic use</subject><subject>Cystectomy - methods</subject><subject>Deoxycytidine - analogs & derivatives</subject><subject>Deoxycytidine - therapeutic use</subject><subject>Female</subject><subject>Humans</subject><subject>IAC</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Urinary Bladder Neoplasms - drug therapy</subject><subject>Urinary Bladder Neoplasms - surgery</subject><subject>动脉</subject><subject>化疗</subject><subject>晚期</subject><subject>灌注</subject><subject>疗效</subject><subject>膀胱癌</subject><subject>顺铂</subject><issn>0366-6999</issn><issn>2542-5641</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kc2O1SAYhonROMfRWzC40Lhp5afQduHCTGbUZBI3uiYU6ClNCx2gTuodeNdDc86ZFZA83_sCDwAfMSppzdEXNctyLG2MrkSU84K3bVsShCnmmLwAB8IqUjBe4Zfg8AxcgTcxjggRxmr-GlyRqkYtrtkB_L_te6uk2qDvYZA67yeotpiMSn7e4DKtEUo9rn-lS9C6FKQMyQS7Y4OZfRpMkMsGH20a4NHMyibZWWegdBoqG5dJJuugd3DyOXvaclrOUkbDbpJamwDVfgxvwateTtG8O6_X4M_d7e-bH8X9r-8_b77dF4ryOhUa4YoQrltTKa6VbBvakIZR1bR9zxTWLaeEUkRNzZpWGkoN63DHmqapaMM5vQafTrmP0vXSHcXo1-Byo_g3qHnMX1mhGmGUwc8ncAn-YTUxidlGZaZJOuPXKDDDVUVJzXBGv55QFXyMwfRiCXaWYRMYiV2byNrEKHZtYrcidivioi3Pvz9Xrd1s9PP0xVMGPpwLBu-ODzZf-8JUbX4sajB9Ah-Yo-o</recordid><startdate>20140405</startdate><enddate>20140405</enddate><creator>Jiang, Lijuan</creator><creator>Zhang, Zhiling</creator><creator>Dong, Pei</creator><creator>Li, Yonghong</creator><creator>Yao, Kai</creator><creator>Liu, Zhuowei</creator><creator>Han, Hui</creator><creator>Qin, Zike</creator><creator>Yao, Min</creator><creator>Zhou, Fangjian</creator><general>Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, China</general><general>State Key Laboratory of Oncology in South China, Guangzhou,Guangdong</general><scope>2RA</scope><scope>92L</scope><scope>CQIGP</scope><scope>W91</scope><scope>~WA</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>2B.</scope><scope>4A8</scope><scope>92I</scope><scope>93N</scope><scope>PSX</scope><scope>TCJ</scope></search><sort><creationdate>20140405</creationdate><title>Efficacy of radical cystectomy plus adjuvant intraarterial chemotherapy with gemcitabine and cisplatin on locally advanced bladder cancer</title><author>Jiang, Lijuan ; Zhang, Zhiling ; Dong, Pei ; Li, Yonghong ; Yao, Kai ; Liu, Zhuowei ; Han, Hui ; Qin, Zike ; Yao, Min ; Zhou, Fangjian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c367t-d014226d9e4c6dca98382853c89ff5c1d96323303e7589ae33e5b1b5888438663</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Cisplatin - therapeutic use</topic><topic>Cystectomy - methods</topic><topic>Deoxycytidine - analogs & derivatives</topic><topic>Deoxycytidine - therapeutic use</topic><topic>Female</topic><topic>Humans</topic><topic>IAC</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Urinary Bladder Neoplasms - drug therapy</topic><topic>Urinary Bladder Neoplasms - surgery</topic><topic>动脉</topic><topic>化疗</topic><topic>晚期</topic><topic>灌注</topic><topic>疗效</topic><topic>膀胱癌</topic><topic>顺铂</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jiang, Lijuan</creatorcontrib><creatorcontrib>Zhang, Zhiling</creatorcontrib><creatorcontrib>Dong, Pei</creatorcontrib><creatorcontrib>Li, Yonghong</creatorcontrib><creatorcontrib>Yao, Kai</creatorcontrib><creatorcontrib>Liu, Zhuowei</creatorcontrib><creatorcontrib>Han, Hui</creatorcontrib><creatorcontrib>Qin, Zike</creatorcontrib><creatorcontrib>Yao, Min</creatorcontrib><creatorcontrib>Zhou, Fangjian</creatorcontrib><collection>中文科技期刊数据库</collection><collection>中文科技期刊数据库-CALIS站点</collection><collection>中文科技期刊数据库-7.0平台</collection><collection>中文科技期刊数据库-医药卫生</collection><collection>中文科技期刊数据库- 镜像站点</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Wanfang Data Journals - Hong Kong</collection><collection>WANFANG Data Centre</collection><collection>Wanfang Data Journals</collection><collection>万方数据期刊 - 香港版</collection><collection>China Online Journals (COJ)</collection><collection>China Online Journals (COJ)</collection><jtitle>Chinese medical journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jiang, Lijuan</au><au>Zhang, Zhiling</au><au>Dong, Pei</au><au>Li, Yonghong</au><au>Yao, Kai</au><au>Liu, Zhuowei</au><au>Han, Hui</au><au>Qin, Zike</au><au>Yao, Min</au><au>Zhou, Fangjian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of radical cystectomy plus adjuvant intraarterial chemotherapy with gemcitabine and cisplatin on locally advanced bladder cancer</atitle><jtitle>Chinese medical journal</jtitle><addtitle>Chinese Medical Journal</addtitle><date>2014-04-05</date><risdate>2014</risdate><volume>127</volume><issue>7</issue><spage>1249</spage><epage>1254</epage><pages>1249-1254</pages><issn>0366-6999</issn><eissn>2542-5641</eissn><abstract>Background Bladder cancer is the ninth most common cancer in the world; fewer than 15% of transitional-cell carcinoma patients survive 2 years if left untreated.Although radical cystectomy is the standard treatment of choice,much of them relapse and the necessity of adjuvant chemotherapy is still under debate.The aim of the study was to evaluate the efficacy of adjuvant intraarterial chemotherapy (IAC) with gemcitabine and cisplatin (GC) on locally advanced bladder cancer.Methods This is a retrospective study on 60 patients with locally advanced bladder carcinoma who underwent radical cystectomy between May 2000 and June 2011.Patients were studied in two groups based on IAC and followed up for up to 5 years.Results Among 60 patients,there were 25 patients who underwent IAC (GC) after radical cystectomy (the IAC group) and 35 patients who underwent radical cystectomy alone (the control group).Although not significant,the relapse rates were slightly reduced in the IAC group than in the control group.Patients with IAC had a reduction in mortality compared with patients without IAC over 5 years.Specifically,IAC significantly reduced about 82% of mortality within the first year (hazard ratio=0.18,95% Cl 0.03-0.97,P=-0.04).Additionally,IAC was well tolerated and safe.The most common adverse effect was transient myelosuppression (10/25,40%),which was resolved by various medical treatments.Conclusions Compared with radical cystectomy alone,radical cystectomy in combination with adjuvant IAC moderately but significantly reduces 1-year mortality.Our preliminary data showed only marginal benefit for the early survival.However,a randomized clinical study is needed to determine the long-term survival benefit.</abstract><cop>China</cop><pub>Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, China</pub><pmid>24709175</pmid><doi>10.3760/cma.j.issn.0366-6999.20131612</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Aged Aged, 80 and over Antineoplastic Agents - therapeutic use Cisplatin - therapeutic use Cystectomy - methods Deoxycytidine - analogs & derivatives Deoxycytidine - therapeutic use Female Humans IAC Male Middle Aged Retrospective Studies Urinary Bladder Neoplasms - drug therapy Urinary Bladder Neoplasms - surgery 动脉 化疗 晚期 灌注 疗效 膀胱癌 顺铂 |
title | Efficacy of radical cystectomy plus adjuvant intraarterial chemotherapy with gemcitabine and cisplatin on locally advanced bladder cancer |
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