Risk Adaptive Neoadjuvant Chemotherapy in Muscle Invasive Bladder Cancer
Journal Title: Üroonkoloji Bülteni - Year 2017, Vol 16, Issue 2
Abstract
Muscle invasive bladder cancer (MIBC) is an aggressive tumor with a high rate of early systemic dissemination. The main treatment for MIBC is still radical cystectomy and lymph node dissection. Survival rates for 5-year are 70-80% for organ-confined disease and 20-30% for extravesical disease. Although surgery provides excellent control for organ-confined bladder cancer, recurrences are common in surgery alone. Therefore, it is important to treat micrometastatic disease with perioperative chemotherapy. Although there are grade 1 evidences for use of cisplatin-based neoadjuvant chemotherapy (NAC), utilization of NAC rates are still very low all over the world. Thus, approaches trying to determine the selection of appropriate patients for NAC were investigated. High-risk groups to benefit from NAC includes palpable mass in the detection under anesthesia before surgery, clinical T3 or T4a disease, hydronephrosis, lymphovascular invasion and aggressive variant histology. Risk adaptive approaches based on clinicopathologic parameters may increase the rate of benefit from NAC until routine usage of molecular markers and methods that can detect micrometastatic disease.
Authors and Affiliations
Elif Atağ, Aziz Karaoğlu, Ömer Küçük
Keywords
Related Articles
- EP ID EP226706
- DOI 10.4274/uob.763
- Views 139
- Downloads 0
Magnetic Resonance - Transrectal Ultrasound Fusion Guided Prostate Biopsy
Prostate has remained as the single solid organ for which biopsy cannot be performed from a lesion for decades. Lately, the groundbreaking magnetic resonance imaging (MRI) techniques have emerged to scan prostate cancer...
Which Patients Should Undergo Immediate or Deferred Cystectomy in Non-Muscle Invazive Bladder Cancer? Evaluation of Selection Criteria
Bladder cancer is the most common malignancy of the urinary tract in Europe. 70% of all muscle invasive is bladder cancer (MIBC) at the time of diagnosis whereas remaining 30% is non-muscle invasive bladder cancer (NMIBC...
A Rare Case of Granulomatous Hepatitis After Intravesical BCG Treatment
Tumor recurrence following transurethral resection is common in non-muscle invasive urothelial cancers of the bladder. Intravesical Bacillus Calmette-Guerin (BCG) is frequently used in urology practice to prevent this re...
Comparison of Subcapsular and Total Orchiectomy in Patients with Prostate Cancer
Objective: We aimed to compare the oncologic and functional outcomes of patients who underwent subcapsular or total orchiectomy for surgical castration in prostate cancer. Materials and Methods: We studied 65 patients w...
Genomic Evaluation of Testicular Germ Cell Tumors and its Role in Treatment Planning
The incidence of testicular germ cell tumors (TGCT) has significantly increased over the last 40 years and continues to increase among the young male population. The geographical differences show that a combination of ge...