Quimioterapia primária com M-VAC no câncer localizado da bexiga: análise de sobrevida após cinco anos
DOI:
https://doi.org/10.32635/2176-9745.RBC.1993v39n4.3044Keywords:
Bladder Cancer, M-Vac ChemotherapyAbstract
Neo-adjuvant M-VAC chemotherapy has been utilized in locally invasive biadder cancer with the hope of destroying inapparent occult micrometastasis and improving patient survival. The authors seta phase II protocol where 3 or 4 cycles of primaryM-VAC chemotherapy (QT) was given to 36 patients with invasive transitional cell carcinoma (TCC) of the bladder. Patients with complete response (CR) to QT had their bladder preserverd and those with partial or no response (PR/NR) or late tumor recurrence were subjected to salvage cystectomy. Thirty 0f 36 patients completed the protocol and were followed for at least 5 years (median = 78 months). Overall, 15 of them or 50% (95% confidence interval, 32% to 68%) were alive and disease-free after 5 years. When the group was stratified according to QT response, 79% of CR and 25% of PR/NR cases were alive and disease-free (p = 0,0002). Considering this data, primary M-VAC in locally invasive TCC of the bladder does not seem to improve overall survival com pared to standard therapeutic modalities. However, this approach seems to stratify cases with better and worse prognosis. Most of patients in the former group are alive and disease-free after 5 years and those in the late group usually have a poor outcome, even with earlier bladder removal.
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