| Author/Editor | Matos, Tadeja; Čufer, Tanja; Červek, Jožica; Borštnar, Simona; Kragelj, Borut; Žumer-Pregelj, Mirjana | |
| Title | Prognostic factors in invasive bladder carcinoma treated by combined modality protocol (organ-sparing approach) | |
| Type | članek | |
| Source | Int J Radiat Oncol Biol Phys | |
| Vol. and No. | Letnik 46, št. 2 | |
| Publication year | 2000 | |
| Volume | str. 403-9 | |
| Language | eng | |
| Abstract | Purpose: The results of bladder sparing approach for the treatment of muscle-invasive baldder cancer, using a combination of transurethral resection (TUR), chemotherapy, and radiotherapy, are encouraging. The survival of patients treated by this method is similar to the survival of patients treated by radical cystectomy. The aim of our study was to find out which pretreatment characteristics influence the survival of patients treated by organ sparing approach that would enable us to identify the patients most suitable for this type of treatment. Methods and materials: The prognostic value of different factors, such as age, gender, performance status, hemoglobin level, clinical stage, histologic grade, presence of obstructive uropathy, and completeness of TUR, has been studied in 105 patients with invasive bladder cancer, who received a bladder sparing treatment in the period from 1988 to 1995. They were treted with a combination of TUR, followed by 2-4 cycles of methotrexate, cisplatinum, and vinblastine polychemotherapy. In complete responders the treatment was completed by radiotherapy (50 Gy to the bladder and 40 Gy to the regional lymph nodes), whereas nonresponders underwent custectomy whenever feasible. Results: Our study has confirmed an independent prognostic value of performance status, histologic grade, and obstructive uropathy, for the disease-specific survival (DSS) of bladder cancer patients treated by a conservative approach. We believe that performance status best reflects the extent of disease and exerts significant influence on the extent and course of treatment, while obstructive uropathy is a godd indicator of local spread of the disease, better than clinical T-stage. Our finding that histologic grade is one of the strongest prognostic factors shows that tumor biology also is a very important prognostic factor in patients treated by conservative approach. (Abstract truncated at 2000 characters). | |
| Descriptors | BLADDER NEOPLASMS COMBINED MODALITY THERAPY PROGNOSIS SURVIVAL ANALYSIS NEOPLASM STAGING ANTINEOPLASTIC AGENTS, COMBINED |