Abstract：Objective: To evaluate the clinical effect of transurethral resection (TUR) of bladder tumor combined with internal iliac artery chemotherapy with or without intravesical instillation therapy for muscle invasive bladder cancer (MIBC). Methods: Seventy-one patients with MIBC were selected and treated with TUR of bladder tumor combined with intravesical instillation therapy, with or without internal iliac artery chemotherapy (chemotherapy regimen: gemcitabine and cisplatin, GC) between February 2007 to June 2014. The bladder preservation and survival rate as well as cancer specific survival rate (CSS) and overall survival rate (OS) of the two groups were compared. Results: Seventy-one patients were followed up for 18-100 months with an average of 59 months. The two-year bladder preserved rate in TUR+GC group and TUR group was 92.9% and 79.3%, respectively (P<0.05). The one-year DFS in TUR+GC group and TUR group was 83.3% and 58.6%, and the 2-year DFS was 78.6% and 62.1% for 2 years, respectively (P<0.05). The 2-year cancer CSS in TUR+GC group and TUR group was 92.9% and 82.8%, respectively (P>0.05). The 2-year OS in TUR+GC group and TUR group was 88.1% and 82.8%, respectively (P>0.05). Conclusions: TURBT and intravesical instillation therapy combine with internal iliac artery chemotherapy for MIBC may have better outcome at recurrence-free survival, bladder preserved rate, DFS than the treatment without internal iliac artery chemotherapy, and there was no difference in OS and CSS.
[1]Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. J Clin, 2012,62(1):10-29. [2]Alferov SM, Grishin MA, Emel'ianenko AV. Endosurgery in treatment of urinary bladder cancer in elderly patients. Khirurgiia (Mosk), 2010,20(9):30-35. [3]Zaghlou MS. Adjuvant and neoadjuvant radiotherapy for bladder cancer: revisited. Future Oncol, 2010,6(7):1171-1191. [4]Hussain M, Theodorescu D. Bladder cancer: bladder preservation-learning what we don't know. Nat Rev Urol, 2014,11(6):310-312. [5]Chen SY, DU LD, Zhang YH. Pilot study of intravesical instillation of two new generation anthracycline antibiotics in prevention of superficial bladder cancer recurrence. Chin Med J (Engl), 2010,123(23):3422-3426. [6]Mantadakis E, Panagiotidis C, Delakas D, et al. Symptomatic relief of patients with advanced bladder carcinoma after regional intra-arterialchemotherapy. Anticancer Res, 2003,23(6D):5143-5147. [7]Khaled HM, Shafik HE, Zabhloul MS, et al. Gemcitabine and cisplatin as neoadjuvant chemotherapy for invasive transitional and squamous cell carcinoma of the bladder: effect on survival and bladder preservation. Clin Genitourin Cancer, 2014,12(5):e233-240. [8]Wilby D, Thomas K, Ray E, et al. Bladder cancer: new TUR techniques. World J Urol, 2009,27(3):309-312. [9]Babjuk M, Oosterlinck W, Sylvester R, et al. EAU guidelines on non-muscle-carcinoma of the bladder. Actas Urol Esp, 2009,33(4):361-71. [10]Ali MH, Ismail IY, Eltobgy A, et al. Evaluation of second-look transurethral resection in restaging of patients with nonmuscle-invasive bladder cancer. J Endourol, 2010,24(12):2047-2050. [11]Sylvester RJ, van der Meijden AP, Oosterlinck W, et al. Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol, 2006,49(3):466-477. [12]Efstathiou JA, Spiegel DY, Shipley WU, et al. Long-term outcomes of selective bladder preservation by combined-modality therapy for invasive bladder cancer: the MGH experience. Eur Urol, 2012,61(4):705-711. [13]Perdonà S, Autorino R, Damiano R, et al. Bladder-sparing, combined-modality approach for muscle-invasive bladder cancer: a multi-institutional, long-term experience. Cancer, 2008,112(1):75-83. [14]Sabaa MA, El-Gamal OM, Abo-Elenen M, et al. Combined modality treatment with bladder preservation for muscle invasive bladder cancer. Urol Oncol, 2010,28(1):14-20. [15]Azuma H, Inamoto T, Takahara K, et al. The novel bladder preservation therapy BOAI-CDDP-radiation (OMC-regimen): a new treatment option for invasive bladder cancer patients with lymph node metastasis. Int J Oncol, 2014,44(6):1895-1903. [16]Hashine K, Kusuhara Y, Miura N, et al.Bladder preservation therapy conducted by intra-arterial chemotherapy and radiotherapy for muscle invasive bladder cancer. Jpn J Clin Oncol, 2009,39(6):381-386. [17]Miyanaga N, Akaza HS, Joraku A,et al. Background variables for the patients with invasive bladder cancer suitable for bladder-preserving therapy. Jpn J Clin Oncol, 2007,37(11):852-857. [18]Shimabukuro T, Nakamura K, Uchiyama K, et al. Angiotensin-II combined intra-arterial chemotherapy for locally advanced bladder cancer: a case series study at a single institution. Hinyokika Kiyo, 2006,52(2):99-105. [19]Chen X, Liao J, Chen L, et al. En bloc transurethral resection with 2-micron continuous-wave laser for primary non-muscle-invasive bladder cancer: a randomized controlled trial. World J Urol, 2015,33(7):989-995. [20]崔昕,李进,王琦,等.2μm 激光与经尿道膀胱肿瘤切除术治疗高级别非肌层浸润性膀胱癌的对比研究.微创泌尿外科杂志,2015,4(3):146-149.
