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Jpn J Clin Oncol. 2007 Nov;37(11):852-7. Epub 2007 Oct 26.

Background Variables for the Patients with Invasive Bladder Cancer Suitable for Bladder-preserving Therapy.

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Department of Urology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba City, Ibaraki 305-8575, Japan.



The present study was undertaken to identify the patients suitable for bladder preservation by analysis of our data.


The subjects of this study were all 72 patients with T2-3N0M0 bladder cancer who underwent bladder-preserving therapy in our institute. The therapy involved intra-arterial chemotherapy with MTX and CDDP and concomitant radiotherapy.


Of the evaluable 70 cases, complete response (CR) was confirmed in 57 cases (81.4%). Among 56 bladder preserved cases, 47 (83.9%) preserved their functioning bladder, and 9 underwent salvage radical cystectomy at the following period. The median follow-up was 45.3 months. The 5-year cause-specific survival rate was 81% and the 5-year overall survival rate was 66%. On the basis of the results of univariate analysis, variables contributing to CR were selected. In T2, tumor size of </=3 cm was scored 0 and >3 cm was scored 1, whereas single tumor was scored 0 and multiple were scored 1. In T3, tumor size of </=3 cm was scored 0 and >3 cm was scored 1, whereas G2 was scored 0 and G3 scored 1. The CR rates were 93.8, 92.6, and 62.9% for total scores of 0, 1, and 2, respectively (P = 0.003; score 0 or 1 versus 2). The overall survival rate was significantly higher in the former group (P = 0.003).


Bladder-preserving therapy can be acceptable for cases of single T2N0M0 tumor with a size of </=3 cm and for T3N0M0 cases with a tumor size of </=3 cm.

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