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논문 기본 정보

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학술저널
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Hongzhe Shi (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Wen Zhang (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Xingang Bi (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Dong Wang (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Zejun Xiao (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Youyan Guan (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Kaopeng Guan (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Jun Tian (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Hongsong Bai (Cancer Hospital of Huanxing Chaoyang District Beijing Beijing China) Linjun Hu (Cancer Hospital of Huanxing Chaoyang District Beijing Beijing China) Chuanzhen Cao (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Weixing Jiang (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Zhilong Hu (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Jin Zhang (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Yan Chen (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Shan Zheng (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Xiaoli Feng (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Changling Li (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Yexiong Li (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Jianhui Ma (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Yueping Liu (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Aiping Zhou (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China) Jianzhong Shou (Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China)
저널정보
대한암학회 Cancer Research and Treatment Cancer Research and Treatment 제53권 제4호
발행연도
2021.10
수록면
1,156 - 1,165 (10page)
DOI
10.4143/crt.2020.1356

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Purpose Reduced quality of life after cystectomy has made bladder preservation a popular research topic for muscle-invasive bladder cancer (MIBC). Previous research has indicated significant tumor downstaging after neoadjuvant chemotherapy (NAC). However, maximal transurethral resection of bladder tumor (TURBT) was performed before NAC to define the pathology, impacting the real evaluation of NAC. This research aimed to assess real NAC efficacy without interference from TURBT and apply combined modality therapies guided by NAC efficacy. Materials and Methods Patients with cT2-4aN0M0 MIBC were confirmed by cystoscopic biopsy and imaging. NAC efficacy was assessed by imaging, urine cytology, and cystoscopy with multidisciplinary team discussion. Definite responders (≤ T1) underwent TURBT plus concurrent chemoradiotherapy. Incomplete responders underwent radical cystectomy or partial cystectomy if feasible. The primary endpoint was the bladder preservation rate. Results Fifty-nine patients were enrolled, and the median age was 63 years. Patients with cT3-4 accounted for 75%. The median number of NAC cycles was three. Definite responders were 52.5%. The complete response (CR) was 10.2%, and 59.3% of patients received bladder-sparing treatments. With a median follow-up of 44.6 months, the 3-year overall survival (OS) was 72.8%. Three-year OS and relapse-free survival were 88.4% and 60.0% in the bladder-sparing group but only 74.3% and 37.5% in the cystectomy group. The evaluations of preserved bladder function were satisfactory. Conclusion After stratifying MIBC patients by NAC efficacy, definite responders achieved a satisfactory bladder-sparing rate, prognosis, and bladder function. The CR rate reflected the real NAC efficacy for MIBC. This therapy is worth verifying through multicenter research.
#Muscle-invasive bladder cancer #Neoadjuvant therapy #Chemoradiotherapy #Combined modality therapy #Organ sparing treatments

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참고문헌 (30)

참고문헌 신청
Antoni S / 2017 / Bladder cancer incidence and mortality : a global overview and recent trends / Eur Urol 71:96~108 google schola Flaig TW / 2019 / NCCN guidelines updates : management of muscleinvasive bladder cancer / J Natl Compr Canc Netw 17:591~593 google schola International Collaboration of Trialists / 2011 / International phase III trial assessing neoadjuvant cisplatin, methotrexate, and vinblastine chemotherapy for muscleinvasive bladder cancer : long-term results of the BA06 30894trial / J Clin Oncol 29:2171~2177 google schola Parekh DJ / 2018 / Robot-assisted radical cystectomy versus open radical cystectomy in patients with bladder cancer(RAZOR) : an open-label, randomised, phase 3, non-inferiority trial / Lancet 391:2525~2536 google schola Yu HY / 2012 / Comparative analysis of outcomes and costs following open radical cystectomy versus robot-assisted laparoscopic radical cystectomy : results from the US Nationwide Inpatient Sample / Eur Urol 61:1239~1244 google schola

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