Neo-adjuvant chemotherapy and bladder preservation in locally advanced transitional cell carcinoma of the bladder

C. N. Sternberg, V. Pansadoro, F. Calabrò, L. Marini, A. Van Rijn, P. De Carli, D. Giannarelli, A. Platania, A. Rossetti

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Background: The possibility of bladder preservation as well as the utility of neo-adjuvant chemotherapy for invasive bladder cancer are controversial issues. The purpose of this study was the evaluation of neo- adjuvant M-VAC chemotherapy and bladder preservation in patients with locally advanced transitional cell carcinoma of the bladder. Patients and methods: Eighty-seven consecutive evaluable patients with T2-T(4a)N(x)M0 TCC of the bladder were treated with three cycles of neo-adjuvant M-VAC chemotherapy. After three cycles of M-VAC, 42 patients had TURB alone, 13 patients underwent partial cystectomy, and 32 patients were to undergo radical cystectomy. Results: Forty (51%) patients were T0 at the TURB following M- VAC. Thirty (71%) patients who had chemotherapy and TURB alone are alive; at a median follow-up of 54+ months (8+-109+). Twenty-four (57%) have maintained an intact bladder. Of 13 responding patients with monofocal lesions who underwent partial cystectomy, 8 patients (62%) are alive with a functioning bladder, at a median follow-up of 80+ months (16-107+ months). At a follow-up of 32 months (7-121+ months), 20 (63%) patients in the radical cystectomy group are alive. In patients who had downstaging to T0 or superficial disease, median follow-up is 55 months (10-121+ months) and five-year survival is 71%. Patients who failed to respond (T2 or greater after chemotherapy), at a median follow-up of 24 months (7-103+ months), had five- year survival of only 29%. Conclusions: Bladder sparing in selected patients on the basis of response to neo-adjuvant chemotherapy is a feasible approach which must be confirmed in prospective randomized trials.

Original languageEnglish
Pages (from-to)1301-1305
Number of pages5
JournalAnnals of Oncology
Issue number11
Publication statusPublished - 1999


  • Bladder preservation
  • Locally advanced bladder cancer
  • Neo-adjuvant chemotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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