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Conservative treatment of invasive bladder cancer.

Rene NJ, Cury FB, Souhami L - Curr Oncol (2009)

Bottom Line: The concept of organ-preserving therapies is a trend in modern oncology, and several tumour types are now treated in this fashion.Trimodality therapy consisting of as thorough a transurethral resection of the bladder tumour as is judged safe, followed by concomitant chemoradiation therapy, is emerging as an attractive alternative for bladder preservation in selected patients with muscle-invasive bladder cancer.Long-term data from multiple institutional and cooperative group studies have shown that this approach is safe and effective and that it provides patients with the opportunity to maintain an intact and functional bladder with a survival rate similar to that for modern radical cystectomy.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, McGill University Health Centre, Montreal, QC.

ABSTRACT
The concept of organ-preserving therapies is a trend in modern oncology, and several tumour types are now treated in this fashion. Trimodality therapy consisting of as thorough a transurethral resection of the bladder tumour as is judged safe, followed by concomitant chemoradiation therapy, is emerging as an attractive alternative for bladder preservation in selected patients with muscle-invasive bladder cancer. Long-term data from multiple institutional and cooperative group studies have shown that this approach is safe and effective and that it provides patients with the opportunity to maintain an intact and functional bladder with a survival rate similar to that for modern radical cystectomy.

No MeSH data available.


Related in: MedlinePlus

Overall survival curves from the Massachusetts General Hospital 9, the University of Erlangen 7, the Radiation Therapy Oncology Group (rtog) 89-03 52, and the University of Southern California 2 studies. Notably, in the cystectomy series from the University of Southern California, 39% of the patients had pT1 or lesser disease, which may explain the apparent better outcome as compared with bladder preservation protocols. Trimodality therapy series using various approaches yield similar 5-year overall survival rates.
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f2-co16-4-36: Overall survival curves from the Massachusetts General Hospital 9, the University of Erlangen 7, the Radiation Therapy Oncology Group (rtog) 89-03 52, and the University of Southern California 2 studies. Notably, in the cystectomy series from the University of Southern California, 39% of the patients had pT1 or lesser disease, which may explain the apparent better outcome as compared with bladder preservation protocols. Trimodality therapy series using various approaches yield similar 5-year overall survival rates.

Mentions: Survival in modern bladder preservation series has improved over that in older publications, when chemotherapy was not given concomitantly with radiotherapy 7,9,33–35,37–39. The current 5-year overall survival ranges from 49% to 67% 7,9,50–52,56. At 10 years, overall survival is 31%–36% 7,9. Figure 2 shows overall survival curves from three bladder preservation protocols 7,47,52 and from one of the largest surgical series 2. Despite small differences in design, the conservative bladder studies show similar survival outcomes. The survival curve from the cystectomy series includes the 39% of patients with pT1 or lesser disease. If patients with only muscle-invasive disease are analyzed, the 5- and 10-year overall survival rates for cystectomy are 48% and 32% respectively— identical to the results achievable with tmt.


Conservative treatment of invasive bladder cancer.

Rene NJ, Cury FB, Souhami L - Curr Oncol (2009)

Overall survival curves from the Massachusetts General Hospital 9, the University of Erlangen 7, the Radiation Therapy Oncology Group (rtog) 89-03 52, and the University of Southern California 2 studies. Notably, in the cystectomy series from the University of Southern California, 39% of the patients had pT1 or lesser disease, which may explain the apparent better outcome as compared with bladder preservation protocols. Trimodality therapy series using various approaches yield similar 5-year overall survival rates.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2722049&req=5

f2-co16-4-36: Overall survival curves from the Massachusetts General Hospital 9, the University of Erlangen 7, the Radiation Therapy Oncology Group (rtog) 89-03 52, and the University of Southern California 2 studies. Notably, in the cystectomy series from the University of Southern California, 39% of the patients had pT1 or lesser disease, which may explain the apparent better outcome as compared with bladder preservation protocols. Trimodality therapy series using various approaches yield similar 5-year overall survival rates.
Mentions: Survival in modern bladder preservation series has improved over that in older publications, when chemotherapy was not given concomitantly with radiotherapy 7,9,33–35,37–39. The current 5-year overall survival ranges from 49% to 67% 7,9,50–52,56. At 10 years, overall survival is 31%–36% 7,9. Figure 2 shows overall survival curves from three bladder preservation protocols 7,47,52 and from one of the largest surgical series 2. Despite small differences in design, the conservative bladder studies show similar survival outcomes. The survival curve from the cystectomy series includes the 39% of patients with pT1 or lesser disease. If patients with only muscle-invasive disease are analyzed, the 5- and 10-year overall survival rates for cystectomy are 48% and 32% respectively— identical to the results achievable with tmt.

Bottom Line: The concept of organ-preserving therapies is a trend in modern oncology, and several tumour types are now treated in this fashion.Trimodality therapy consisting of as thorough a transurethral resection of the bladder tumour as is judged safe, followed by concomitant chemoradiation therapy, is emerging as an attractive alternative for bladder preservation in selected patients with muscle-invasive bladder cancer.Long-term data from multiple institutional and cooperative group studies have shown that this approach is safe and effective and that it provides patients with the opportunity to maintain an intact and functional bladder with a survival rate similar to that for modern radical cystectomy.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, McGill University Health Centre, Montreal, QC.

ABSTRACT
The concept of organ-preserving therapies is a trend in modern oncology, and several tumour types are now treated in this fashion. Trimodality therapy consisting of as thorough a transurethral resection of the bladder tumour as is judged safe, followed by concomitant chemoradiation therapy, is emerging as an attractive alternative for bladder preservation in selected patients with muscle-invasive bladder cancer. Long-term data from multiple institutional and cooperative group studies have shown that this approach is safe and effective and that it provides patients with the opportunity to maintain an intact and functional bladder with a survival rate similar to that for modern radical cystectomy.

No MeSH data available.


Related in: MedlinePlus