Treatment Approach for Muscle-Invasive Bladder Cancer: Real-Life Data From a Single Center
Elif Atag1, Ezgi Coban1, Murat Sari1, Eda Tanrikulu2, Ramazan Topaktas3, Gulistan Gumrukcu4, Metin Ishak Ozturk51Department of Medical Oncology, Haydarpasa Numune Training and Research Hospital, Istanbul, Türkiye, 2Department of Medical Oncology, Anadolu Health Center, Kocaeli, Türkiye, 3Department of Urology, Haydarpasa Numune Training and Research Hospital, Istanbul, Türkiye Department of Urology, Haydarpasa Numune Training and Research Hospital, Istanbul, Türkiye, 4Department of Pathology, Haydarpasa Numune Training and Research Hospital, Istanbul, Türkiye Department of Pathology, Haydarpasa Numune Training and Research Hospital, Istanbul, Türkiye, 5Department of Urology, Haydarpasa Numune Training and Research Hospital, Istanbul, Türkiye
Objectives: We aimed to reveal the treatments of patients with muscle-invasive bladder cancer and the results of treatments in our center. We also evaluated factors affecting progression-free survival and overall survival. Methods: The patients are divided into 5 categories based on the treatment types: (i) only surgery, (ii) surgery + adjuvant chemotherapy, (iii) neoadjuvant chemotherapy + surgery, (iv) neoadjuvant chemotherapy + chemoradiotherapy, (v) definitive chemoradiotherapy. Results: A total of 118 patients were included in this study. 3-year progression-free survival rate was 34% in only surgery group (n=42), 53% in surgery + adjuvant chemotherapy (n=40), 45% in neoadjuvant chemotherapy + surgery (n=8), 0% in neoadjuvant chemotherapy + chemoradiotherapy (n=6) and 26% in definitive chemoradiotherapy (n=21). 5-year survival rate was respectively 31%, 44%, 53%, 25%, and 19% in these groups. ECOG performance status of 1-3, pathological T stage 3-4, surgical margin positivity, and not receiving adjuvant chemotherapy were independent risk factors for disease progression. Pathological T stage 3-4 (HR:8.2 CI 2.4-27.4, p<0.01) and receiving incomplete chemotherapy (HR:3.9 CI 1.9-8, p<0.01) in adjuvant/neoadjuvant setting were independent risk factors for mortality. Conclusion: Adjuvant chemotherapy and neoadjuvant chemotherapy were not used sufficiently in muscle-invasive bladder cancer. Surgery + adjuvant chemotherapy showed a survival advantage over only surgery and chemoradiotherapy. The pathological T stage is the best prognostic factor. Receiving complete systemic treatment in an adjuvant / neoadjuvant setting is related to overall survival. Keywords: Bladder cancer, muscle-invasive, neoadjuvant chemotherapy, survival, treatment
Cite This Article
Atag E, Coban E, Sari M, Tanrikulu E, Topaktas R, Gumrukcu G, Ozturk M. Treatment Approach for Muscle-Invasive Bladder Cancer: Real-Life Data From a Single Center. EJMI. 2023; 7(1): 22-31
Corresponding Author: Elif Atag