Bladder Urothelial Carcinoma
Conditions
Keywords
survival benefits, neoadjuvant CTH, bladder cancer
Brief summary
Muscle-invasive bladder cancer (MIBC) is an aggressive disease with a high-risk of early metastasis and cancer specific mortality. The gold standard treatment of MIBC is radical cystectomy (RC) in conjunction with concomitant bilateral pelvic lymphadenectomy . While radical cystectomy remains a primary management strategy for MIBC, high rates of recurrence with surgery alone highlight the likelihood of occult micrometastatic disease at the time of diagnosis. Due to the development and implementation of neoadjuvant chemotherapy prior to radical cystectomy, the prognosis for MIBC patients undergoing radical cystectomy has improved .
Detailed description
The goals of neoadjuvant chemotherapy administration are to; eradicate the micro-metastases, avoid the release and implantation of malignant cells during cystectomy, and extend the survival of these patients. Clinical trial data supports the use of neoadjuvant platinum-based chemotherapy for patients with non-metastatic MIBC. Based on Level I evidence, use of preoperative platinum based chemotherapy is now included in the guideline recommendations from the American Urologic Association (AUA), American Society of Clinical Oncology (ASCO), National Comprehensive Cancer Network (NCCN), and European Association of Urology (EAU) . In the Southwest Oncology Group (SWOG) Intergroup study, RC alone was compared with three cycles of neoadjuvant MVAC (methotrexate, vinblastine, doxorubicin, and cisplatin), followed by radical cystectomy. This randomized trial showed that the median survival duration was 77 months in patients with combination treatment, and 46 months in patients with upfront RC alone.
Interventions
medical records that patients received neoadjuvant systemic chemotherapy platine based
Sponsors
Sara Mahmoud Ahmed Mahmoud
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age \>18 * histological proven MIBC patient treated with neoadjuvant systemic chemotherapy( platinum based )
Exclusion criteria
* Non muscle invasive bladder cancer (NMIBC) * Metastatic patients * Patients treated with surgery firstly
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Evaluating the factors affecting the response of neoadjuvant chemotherapy in muscle invasive bladder cancer | 3 to 6 months (from previous medical reports ) | evaluating the neoadjuvant respose by clinical examination and radiological tools ( CT , MRI ) according to Recist criteria |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Disease free survival (DFS) | thorough study completion (an average 1 year ) | DFS the length of time after primary treatment for a cancer ends that the patient survives without any signs or symptoms of that cancer. |
| overall survival (OS) | from the randomization until the date of 1st decument progression or death from any cause , whichever come first assesed up to 100 weeks | OS: defined as the length of time from either the date of diagnosis or the start of treatment for cancer, that patients are still alive. |
| Progression Free Survival ( PFS ) | an average 2 years | the average lenght of time after the start of treatment in which a person is alive and their cancer does not grow or spread |
Contacts
Primary ContactSara Mahmoud Ahmed, resident
Backup ContactRehab Farouk Mohamed, professor
Outcome results
None listed