Posted on March 19th, 2010 by
Combined modality therapy (CMT) preserves the bladder, achieves complete response (CR), and offers long-term survival in approximately 70% of patients with invasive bladder cancer, according to the results of a 15-year study presented at 2010 American Society of Clinical Oncology Genitourinary Symposium March 5-7 in San Francisco.
The bladder is a hollow organ located in the pelvis. Its primary function is to store urine. The bladder has a muscular wall that allows it to get larger and smaller as urine is stored or emptied. Bladder cancer is diagnosed in roughly 50,000 men and 17,000 women annually in the United States.
Patients with T2-T4 bladder cancer have cancer that is considered non-metastatic but that has invaded the muscle wall. Historically, these cancers have been treated with radical cystectomy, which refers to complete surgical removal of the bladder. More recently, however, several studies have supported the bladder preservation measures offered by treatment with combined modality therapy (CMT), which consists of transurethral resection bladder tumor (TURBT), radiation therapy, and chemotherapy.
Researchers from Massachusetts General Hospital presented 15-year outcomes from a study that involved 348 patients with cT2-T4aNxMO bladder cancer who were treated with TURBT, radiation, and chemotherapy. Seventy-two percent of patients had a complete response to induction therapy. Rates of disease-free survival were 64% at five years, 59% at 10 years, and 57% at 15 years. Overall survival rates were 52% at five years, 35% at 10 years, and 22% at 15 years. The survival rates were slightly higher among the subset of patients who had Stage T2 cancer than they were among those with T3-T4 disease. Neoadjuvant therapy did not appear to improve outcomes.
The researchers concluded that approximately 70% of patients treated with CMT achieved complete response and that long-term survival rates were comparable to those achieved with more radical surgery.
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