Retrospective analysis of the efficacy of two cycles of M-VAC neoadjuvant chemotherapy followed by radical cystectomy for muscle-invasive bladder cancer.
BACKGROUND
Neoadjuvant chemotherapy before radical cystectomy for muscle-invasive bladder cancer is a commonly used treatment modality. However, in terms of chemotherapeutic regimens and the number of cycles of neoadjuvant chemotherapy, there is yet no international consensus, as various studies indicate the efficacy of several platinum-based combination chemotherapeutic regimens. We determined the efficacy of two cycles of neoadjuvant chemotherapy with methotrexate, vinblastine, adriamycin, and cisplatin followed by radical cystectomy.


PATIENTS AND METHODS
The study population included patients with clinical stage T2 - T4a, N0, M0 bladder cancer who underwent radical cystectomy. Clinical courses were compared between 27 patients treated with two cycles of M-VAC neoadjuvant chemotherapy and 25 treated with cystectomy alone.


RESULTS
The incidence of pT0 was 25.9% in the group treated with neoadjuvant chemotherapy. The probabilities of disease-free and cause-specific survival were significantly higher in patients treated with, than without neoadjuvant chemotherapy. On univariate Cox proportional hazards regression analysis for the patients treated with neoadjuvant chemotherapy, pathological stage and the pathological findings of venous involvement were significant prognostic factors.


CONCLUSION
The results of this retrospective study demonstrated the clinical effectiveness of two cycles of neoadjuvant M-VAC chemotherapy for muscle-invasive bladder cancer.
['Kitagawa|Yasuhide|Y|', 'Izumi|Kouji|K|', 'Miwa|Sotaro|S|', 'Kadono|Yoshifumi|Y|', 'Konaka|Hiroyuki|H|', 'Mizokami|Atsushi|A|', 'Namiki|Mikio|M|']
D000368:Aged D000971:Antineoplastic Combined Chemotherapy Protocols D002295:Carcinoma, Transitional Cell D017024:Chemotherapy, Adjuvant D002945:Cisplatin D015653:Cystectomy D018572:Disease-Free Survival D004317:Doxorubicin D005260:Female D006801:Humans D053208:Kaplan-Meier Estimate D008207:Lymphatic Metastasis D008297:Male D008727:Methotrexate D008875:Middle Aged D020360:Neoadjuvant Therapy D009361:Neoplasm Invasiveness D016016:Proportional Hazards Models D012189:Retrospective Studies D016896:Treatment Outcome D001749:Urinary Bladder Neoplasms D014747:Vinblastine
neoadjuvant chemotherapy Muscle-invasive bladder cancer MVAC chemotherapy