Science et thérapie du cancer

Intra-arterial Combination Chemotherapy with Maximum Transurethral Resection of Bladder Tumour for T1 Grade 3 and T2--3N0M0 Bladder Cancers

Abstract

Kaoru Nemoto, Narumi Tsuboi, Takafumi Miura, Go Shioji, Hiroshi Kawamata, Susumu Okada, Yoshiharu Ohaki, Ryoji Kimata and Yukihiro Kondo

Purpose: We evaluated the clinical outcomes following intra-arterial chemotherapy with maximum transurethral resection of bladder tumour (TURBT) for patients with T1 grade 3 (G3) and T2--3N0M0 bladder cancers. Material and methods: Patients were 27 males and 7 females with a median age of 63.6 years. With the cooperation of an interventional radiologist, cisplatin (100 mg/m2), methotrexate (30 mg/m2) and adriamycin (20 mg/ body) were administered via a catheter in 2 cycles every 4 weeks. Results: The 5-year cancer-specific survival rate in T1 G3, T2 and T3 was 100.0%, 57.3% and 50.0%, respectively. In T2--3N0M0 cases, complete response (CR) and non-CR were seen in 13 (46.4%) and 15 cases (53.6%), respectively. Response to treatment proved to be the most significant prognostic predictor of cancerspecific survival by multivariate analysis in T2--3N0M0 cases. T2--3N0M0 cases with ?2 prognostic predictors at staging TURBT (age >70 years, male, size >3 cm and the presence of hydronephrosis) had an unfavourable outcome. There was a statistical association between the number of prognostic predictors at staging TURBT and response to treatment. Conclusion: These results suggest that our protocol prevents disease progression in T1 G3 cases, but that it is not suitable for T2--3N0M0 cases with ?2 prognostic predictors at staging TURBT.