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[Impact of neoadjuvant chemotherapy on therapeutic management of muscle-invasive bladder cancer]. / Impact de la chimiothérapie néoadjuvante sur la prise en charge des tumeurs de vessie infiltrant le muscle.
Meyer, V; Flechon, A; Tartas, S; Fassi-Fehri, H; Ruffion, A; Martin, X; Colombel, M.
Afiliación
  • Meyer V; Service d'urologie et chirurgie de la transplantation, hospices civils de Lyon, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France. Electronic address: vincent-meyer@hotmail.fr.
  • Flechon A; Département d'oncologie médicale, centre Léon-Bérard, 28, rue Laennec, 69008 Lyon cedex 08, France.
  • Tartas S; Service de chirurgie urologique, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
  • Fassi-Fehri H; Service d'urologie et chirurgie de la transplantation, hospices civils de Lyon, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
  • Ruffion A; Service de chirurgie urologique, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
  • Martin X; Service d'urologie et chirurgie de la transplantation, hospices civils de Lyon, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
  • Colombel M; Service d'urologie et chirurgie de la transplantation, hospices civils de Lyon, hôpital Édouard-Herriot, 5, place d'Arsonval, 69003 Lyon, France.
Prog Urol ; 25(2): 83-9, 2015 Feb.
Article en Fr | MEDLINE | ID: mdl-25482920
OBJECTIVE: Assess the toxicity of neoadjuvant chemotherapy (NAC), its impact on surgical schedule and postoperative morbidity of cystectomy for muscle-invasive bladder cancer (MIBC). PATIENTS AND METHODS: Retrospective multicentric study of 78 patients who underwent a cystectomy from January 2009 to March 2012 for MIBC. The following criteria have been studied: toxicity of NC (WHO classification), precystectomy interval, postoperative morbidity (Clavien), duration of stay, downsizing on CT-scan before cystectomy, and free of cancer pathology (pT0). RESULTS: Seventy-eight patients had been included, thirty-nine had a NAC. Thirty-three percent had a incomplete chemotherapy because of toxicity. Forty-eight percent had a significant toxicity and grade ≥ 3 toxicity was 33%. Median time between diagnosis and cystectomy was 12.6 weeks (0.7-38), 18 weeks with NAC (group 1) versus eight weeks without NAC (group 2) (P=0.01). In case of toxicity, the delay was 3.5 weeks longer (P=0.12). After cystectomy, 60% of patients had at least one postoperative complication; including 23% had major morbidity. NAC did not increase neither postoperative morbidity (P=0.15) nor duration of stay (18 vs 20 days; P=0.2). Radiological response rate to NC was 38%. pT0 rate was 79 vs 7.7%. The increase of precystectomy interval after NC did not worsen the pathological stage (P=0.5). CONCLUSION: NC had a high toxicity, but without impact on postoperative morbidity, and precystectomy interval did not have any impact on the prognosis. LEVEL OF EVIDENCE: 5.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Vejiga Urinaria Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: Fr Revista: Prog Urol Asunto de la revista: UROLOGIA Año: 2015 Tipo del documento: Article Pais de publicación: Francia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Vejiga Urinaria Tipo de estudio: Observational_studies / Prognostic_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: Fr Revista: Prog Urol Asunto de la revista: UROLOGIA Año: 2015 Tipo del documento: Article Pais de publicación: Francia