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
Hauptverfasser: Jiang, Lijuan, Zhang, Zhiling, Dong, Pei, Li, Yonghong, Yao, Kai, Liu, Zhuowei, Han, Hui, Qin, Zike, Yao, Min, Zhou, Fangjian
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container_end_page 1254
container_issue 7
container_start_page 1249
container_title Chinese medical journal
container_volume 127
creator Jiang, Lijuan
Zhang, Zhiling
Dong, Pei
Li, Yonghong
Yao, Kai
Liu, Zhuowei
Han, Hui
Qin, Zike
Yao, Min
Zhou, Fangjian
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 &amp; 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 ; 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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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