SAN FRANCISCO, CA USA (UroToday.com) - Dr. Timur Mitin presented an abstract comparing outcomes in complete and near-complete responses (CR and nCR) in bladder preservation protocols.
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Previous randomized studies in bladder preservation protocols necessitated a radical cystectomy for patients with residual disease after induction therapy. However, pathological analyses of these specimens showed that many of the patients had minimal residual disease. This prompted the RTOG to determine if such minimal residual disease can be safely managed without cystectomy.
Dr. Mitin presented the data from RTOG 9906 which was a single-arm prospective trial of bladder preservation with twice daily radiation and radio-sensitizing chemotherapy, and also data from RTOG 0233 which was a randomized controlled trial assessing two different chemotherapy regimens, in addition to radiation. He compared the outcomes of CR (n=101) and nCR (n=18) patients and showed that there was no significant difference in recurrence, muscle-invasive recurrence, salvage cystectomy rates, or overall survival. This suggests that patients with non-muscle invasive disease, after bladder preservation protocols, may be safely observed and managed endoscopically.
Highlights of a presentation by Timur Mitin, MD, PhD at the 2014 Genitourinary Cancers Symposium - January 30 - February 1, 2014 - San Francisco Marriott Marquis - San Francisco, California USA
Massachusetts General Hospital, Boston, MA USA