Long-term efficacy of one-shot intra-arterial chemotherapy before radical cystectomy

doi:10.3969/j.issn.1006-7795.2018.03.019

Abstract

Abstract: Objective Evaluation of long-term outcome of one-shot intra-arterial chemotherapy as new adjuvant therapy before laparoscopic radical cystectomy(LRC).Methods We retrospectively analyzed the preoperative clinical data and follow-up results of 26 patients who received one-shot intra-arterial chemotherapy before LRC in Urology Department of Beijing Chaoyang Hospital from February 2006 to December 2015.Results All patients were performed one-shot intra-arterial chemotherapy 2-4 weeks before the LRC and completed laparoscopic procedure without open conversion (ileal conduit urinary diversion for 9 patients, orthotopic ileal neobladder for 15 patients and cutaneous ureterostomy for 2 patients). The average operation time was 373 min (210-600 min) with estimated blood loss of 407 mL (100-1 400 mL). All pathology was urothelial cell carcinoma of the urinary bladder with 6 low grade and 20 high grade. No positive surgical margins were reported. Compared with clinical TNM stages, pathological TNM stages demonstrated significant decrease (P=0.002):7 cases had no changed, 17 cases achieved a stage decrease, and 2 cases had risen. The average lymph node number was 17 (8-28) including 8 positive cases. There was no statistical difference in 30-day postoperative complications between the low grade and high grade tumor (P=0.081). The number of Clavien level 3 or higher complications within 30 day, 30 to 90 days, and more than 90 days were 3 cases, 1 case and 2 cases, respectively. The patients were followed up for 88 months (2-121 months). There were two cancer-specific deaths and one died of other causes during the follow-up period; however, no difference was found in terms of overall survival (P=0.746) and cancer specific survival(P=0.446) between the low grade and high grade tumor.Conclusion With long-term follow-up, one-shot intra-arterial chemotherapy did not significantly increase the post-operative complications, at the same time significantly decreased the pathological stage and grade. Randomized trials will be required to better assess the oncology outcome.

Key words: bladder cancer, intra-arterial chemotherapy, outcomes

CLC Number:

R737.14

Wasilijiang·Wahafu, Liu Sai, Wang Mengtong, He Qingbao, Song Liming, Ping Hao, Wang Mingshuai, Yang Feiya, Tian Xiquan, Niu Yinong, Xing Nianzeng. Long-term efficacy of one-shot intra-arterial chemotherapy before radical cystectomy[J]. Journal of Capital Medical University, 2018, 39(3): 418-422.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2018.03.019

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2018/V39/I3/418

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