Evaluation of influence of systemie chemotherapy on survival of patients with bladder tumour treated by means of electroresection
Article published in Urologia Polska 2003/56/1.

authors

Wojciech Kołaczyk ¹, Janusz Dembowski ², Jarosław Lewandowski ¹, Krzysztof Dudek ³, Jerzy Lorenz ²: ¹ Oddział Urologii Szpitala Wojewódzkiego w Legnicy
Ordynator oddziału: dr Wojciech Kolac2yk
² Katedra i Klinika Urologii Akademii Medycznej we Wrocławiu
Kierownik kliniki: prof, dr hab. Jerzy Lorenz
³ Zakład Inżynierii Niezawodności i Diagnostyki Politechniki Wrocławskiej
Kierownik zakładu: prof, dr hab. Dionizy Dudek

keywords

bladder, invasive bladder cancer, systemic chemotherapy, transurethral resection

summary

Aim of study. Assessment of survival of patients treated for invasive bladder cancer with the use of transurethral electroresection of tumour in comparison with a group of patients where Tl.\'RBT was followed by systemic chemotherapy according to modified scheme MVAC. as an additional treatment.

Material and method. Patients treated for invasive bladder cancer between 1989 and 2002 in Urological Clinic of Medical Academy in Wrocław and Urological Department of District Hospital in Legnica, who were not submitted (o radical cystectomy. Patients were divided into two groups. The first (group E: 27 patients) included patients treated only with transurethral electroresection of the tumour, the second (group E+CH: 67 patients) included cases where electroresection was followed by systemic chemotherapy according to modified scheme MVAC. Additionally, the patients were divided into two sub-groups. The first consisted of patients with tumour confined to the organ itself (T2+T3 a), the second of- patients with tumour expanding beyond the bladder (T3b+T4a+T4b). As there were few patients treated only with electroresection in the subgroup where tumour expanded beyond the organ, survival rale was evaluated only among patients with tumour confined to the organ. In this subgroup. 24 patients were treated only with electroresection, whereas 40 patients received additional chemotherapy. Statistical analysis was carried out with the use of Kaplan-Meier method.

Results. Patients with invasive bladder cancer with the tumour confined to the organ (T2+T3a) treated with transurelhral electroresection of the tumour as well as systemic chemotherapy according to modified scheme MVAC, were found to have higher survival rate compared to patients treated only with transurethral electroresection (p<0.01).

Conclusions. In special cases, when there are indications for removal of bladder in patients with invasive bladder cancer but the patients do not agree to radical cystectomy, tninsurethal resection of the bladder tumor should be associated with systemic chemotherapy.

references

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