Potential To Prevent Recurrence Of Bladder Tumors After Surgical Removal Of Upper Urinary Tract Transitional Cell Carcinoma

Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology
Article Date: 03 Sep 2008 - 1:00 PDT

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UroToday.com - In this article from the International Journal of Urology, the authors evaluated the survival benefit and prevention of bladder cancer recurrence with adjuvant platinum based chemotherapy, in upper urinary tract urothelial cancer, following surgical resection. Between April 1986 and August 2005, 132 patients with upper urinary tract urothelial cancer underwent radical nephroureterectomy with bladder cuff. 46 patients (13 with pT2pN0M0 and 33 with pT3 pN0M0 transitional cell carcinoma without prior bladder cancer) were enrolled in the clinical study. Patients with locally advanced disease were divided into two groups: the adjuvant chemotherapy group (24 patients) who received adjuvant methotrexate, vinblastine, adriamycin, and cisplatin (M-VAC) and the non-adjuvant chemotherapy group (22 patients).

There were no statistically significant differences in patient characteristics or 10-year survival between the two groups. The recurrence rate in the non-adjuvant chemotherapy group was significantly higher than in the adjuvant chemotherapy group (log-rank test, P < 0.0001). Only non-adjuvant chemotherapy was a significant and independent risk factor (hazard ratio 6.97) for the development of intravesical recurrence (P < 0.01).

The authors concluded that adjuvant chemotherapy can prevent recurrent bladder tumors and non-bladder tumor recurrence following surgery for upper urinary tract transitional cell carcinoma. Adjuvant chemotherapy should be considered for patients with upper tract urothelial carcinoma.

Soga N, Arima K, Sugimura Y
Int J Urol. 2008 Jul 21. Epub ahead of print.
Reported by UroToday.com Contributing Editor David P. Wood, MD

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