[Stage T4 bladder cancer. Impact of neoadjuvant chemotherapy on T4b tumors]

Arch Esp Urol. 1990:43 Suppl 2:205-8.
[Article in Spanish]

Abstract

The present article studied the biological behaviour of T4a versus T4b tumors. Of 29 patients with T4a tumors, 24 were treated by radical cystectomy and 5 were treated by diversion alone on detecting pathologic gross adenopathies at laparotomy. Of these 10/28 (35.7%) are alive and tumor-free. Of 11 patients with T4b tumors, 7 were initially treated with systemic chemotherapy (6 M-VAC and 1 5-FU + ADM) which achieved a clinical response in 4; 1 (14.2%) was RCc. Posteriorly, all these patients underwent radical cystectomy that revealed 2 had RPp and 2 had tumor progression (N+), accounting for an RPp rate of 28.5% and tumor progression of 71.5%. Overall, with a mean follow-up of 13.3 months, only 1 patient is tumor free. The foregoing findings show the different behaviour of these two groups of patients with an incidence of tumor positive adenopathies of 48.2% and 72.7% and tumor-free survival of 35.7% and 9.0% for patients with T4a and T4b, respectively.

Publication types

  • Clinical Trial
  • Comparative Study
  • English Abstract

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cisplatin / administration & dosage
  • Combined Modality Therapy
  • Doxorubicin / administration & dosage
  • Female
  • Fluorouracil / administration & dosage
  • Humans
  • Lymphatic Metastasis
  • Male
  • Methotrexate / administration & dosage
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Prognosis
  • Survival Rate
  • Urinary Bladder Neoplasms / drug therapy
  • Urinary Bladder Neoplasms / pathology*
  • Urinary Bladder Neoplasms / surgery
  • Urinary Diversion
  • Vinblastine / administration & dosage

Substances

  • Vinblastine
  • Doxorubicin
  • Cisplatin
  • Fluorouracil
  • Methotrexate

Supplementary concepts

  • M-VAC protocol