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Respuesta y supervivencia libre de progresión en tumores vesicales en estadiosT2-T4 tratados con tratamiento trimodal de conservación vesical
Other Titles: Response and progression-free survivalinT2toT4 bladder tumors treated with trimodality therapy with bladder preservation
Authors: Rincon-Mayans, A. (Anibal)
Rosell, D. (David)
Zudaire, J.J. (Juan Javier)
Rioja-Zuazu, J. (Jorge)
Barba, J.F. (Javier Fermín)
Tolosa-Eizaguirre, E. (Egoitz)
Romero-Vargas, L. (Luis)
Pascual-Piedrola, J.I. (Juan Ignacio)
Keywords: Bladder cancer
Quimiotherapy
Radiotherapy
Issue Date: 2010
Publisher: Elsevier España
Publisher version: http://dx.doi.org/10.1016/j.acuro.2010.04.008
ISSN: 0210-4806
Citation: Rincon Mayans A, Rosell Costa D, Zudaire Bergera JJ, Rioja Zuazu J, Barba Abad J, Tolosa Eizaguirre E, et al. Respuesta y supervivencia libre de progresión en tumores vesicales en estadiosT2-T4 tratados con tratamiento trimodal de conservación vesical. Actas Urol Esp 2010 Oct;34(9):775-780
Abstract
Objective: Toevaluatetheresponseandthefree-survivalprogressioninpacientsdiagnosed of invasivebladdercancerwhohavebeentreatedwithtransurethralresection, chemotherapyandradiotherapy.Thismultimodaltreatmentiscomparedwithanot random serieofpatientstreatedbyradicalcistectomy. Material andmethods: Retrospectiveanalysisof43casesofinvasivebladdercancertreated with twoschemesofbladderpreservationbetween1994–2007.Theyarecomparedwith145 cases treatedwithradicalcistectomyinthesameperiodoftime. Pronosticvariablesincludedinthestudyareclinicalstage,gradeofdifferentiation, presence ofureteralobstruction,chemotherapymodality,radiotherapydosesandp53and ki-67 expression. Results: Meanandmediantimeare51and39monthsinpatientswithmultimodal treatment.Completeresponseisachievedin72%ofcasestreatedwithbladder preservation.Ureteralobstructionisaprognosticfactor(OR:7,3;p:0,02).72%patientswith complete responsemantainitattheendofthestudy.Noneofanalyzedvariablesare predictors ofmaintenanceoftheresponse. Survivalrateswithaintactbladderwere6977% and6177% atthreeandfiveyears. Radiotherapydosesgreaterthan60Gy(OR:6,1;po0,001) andtheabsenceofureteral obstruction (OR:7,5;po0,002) werepronosticvariables. Free-survivalinpatientswithcompleteresponsewas8077% and58710% atthreeand five years. At theendofthestudy,53,5%ofpatientshadaintactbladderandfree-disease. Inthesameperiodoftime,145radicalcistectomieswereperformedduetomuscleinvasive bladdercancer.Meanandmediantimeinthisgroupwere29and18monthsrespectively. Stadisticalanalysisrevealsaworseclinicalstageinthegroupofpatientstreatedwith multimodaltreatment(p:0.01). Free-survivalwas7275% and6377%at3and5yearsinthegroupofradical cistectomies.Therewasnotstadisticalsignificantdifferencesbetweencistectomiesand bladderpreservation. Conclusions: Patientstreatedwithbladderpreservationhaveafree-survivalsimilartothose tretedwithradicalcistectomy.Radiotherapy doses greaterthan60Gyandabsenceofureteral obstructionwerefree-survivalprognosticvariables.
Permanent link: http://hdl.handle.net/10171/22448
Appears in Collections:DA - CUN - Urología - Artículos de revista

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