Transurethral resection of bladder tumor (TURBT), radiotherapy, chemotherapy, or combinations can be used in patients with muscle-invasive bladder cancer (MIBC) not undergoing cystectomy. Nevertheless, unfitness for cystectomy is frequently associated with unfitness for other therapeutic modalities.
We report the outcome of patients with MIBC who did not undergo cystectomy and did not receive cisplatin-based chemotherapy. Selection criteria for the study were nonmetastatic MIBC, no cystectomy, no cisplatin-based chemotherapy. Chemotherapy and/or radiotherapy should have been used aside from TURBT. Forty-nine patients (median age 79), managed between April 2001 and January 2012, were included in this analysis. Median Charlson Comorbidity Index was 5, while 76% were unfit for cisplatin. Treatment included radiotherapy (n = 7), carboplatin-based chemotherapy (n = 25), carboplatin-based chemotherapy followed by radiotherapy (n = 10), and radiochemotherapy (n = 7). Five-year event-free rate was 26% (standard error [SE] = 7) for overall survival, 23% (SE = 7) for progression-free survival, and 30 (SE = 8) for cancer-specific survival (CSS). Patients who were treated with combination of radiotherapy and chemotherapy had significantly longer CSS compared to those treated with radiotherapy or chemotherapy only (5-year CSS rate: 16% [SE 8] vs. 63% [SE 15], P = 0.053). Unfit-for-cystectomy patients frequently receive suboptimal nonsurgical treatment. Their outcome was poor. Combining chemotherapy with radiotherapy produced better outcomes and should be prospectively evaluated.
Cancer medicine. 2016 Mar 22 [Epub ahead of print]
Aristotle Bamias, Petros Tsantoulis, Thomas Zilli, Athanasios Papatsoris, Francesca Caparrotti, Christos Kyratsas, Kimon Tzannis, Kostas Stravodimos, Michael Chrisofos, Gregory J Wirth, Andreas Skolarikos, Dionysios Mitropoulos, Constantinos A Constantinides, Charalambos Deliveliotis, Christophe E Iselin, Raymond Miralbell, Pierre-Yves Dietrich, Meletios A Dimopoulos
Hellenic Genito-Urinary Cancer Group, Athens, Greece., Department of Oncology and Centre de Recherche Clinique Dubois Ferrari, Geneva University Hospital, Geneva, Switzerland., Department of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland., Hellenic Genito-Urinary Cancer Group, Athens, Greece., Department of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland., Hellenic Genito-Urinary Cancer Group, Athens, Greece., Department of Clinical Therapeutics, Medical School, Athens University, Athens, Greece., Hellenic Genito-Urinary Cancer Group, Athens, Greece., Hellenic Genito-Urinary Cancer Group, Athens, Greece., Department of Urology Department, Geneva University Hospital, Geneva, Switzerland., Hellenic Genito-Urinary Cancer Group, Athens, Greece., Hellenic Genito-Urinary Cancer Group, Athens, Greece., Hellenic Genito-Urinary Cancer Group, Athens, Greece., Hellenic Genito-Urinary Cancer Group, Athens, Greece., Department of Urology Department, Geneva University Hospital, Geneva, Switzerland., Department of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland., Department of Oncology and Centre de Recherche Clinique Dubois Ferrari, Geneva University Hospital, Geneva, Switzerland., Hellenic Genito-Urinary Cancer Group, Athens, Greece.