PREOPERATIVE ADJUVANT THERAPY FOR URINARY BLADDER CANCER

Preoperative Intra-Arterial Anticancer Drugs Infusion Using Artificial Liver, and Preoperative Radiotherapy

Abstract

One hundred patients with carcinoma of the urinary bladder were treated with preoperative intra-arterial anticancer drug infusion in combination with an active carbon-based artificial liver or preoperative radiotherapy (400 rad ×5 days, total 2000 rad) in order to alleviate systemic side effects after preoperative adjuvant therapy and to perform radical cystectomy as soon as possible. Five-year survival was 69.8% in the artificial liver combined preoperative intra-arterial anticancer drug infusion group, and that of the no-pretreatment group and the preoperative irradiated group was 48.6% and 45.8%, respectively. In particular, the CDDP treated group had a higher 5-year survival of 77.4% than did the without CDDP treated group. This was attributable mostly to improved prognosis of T₂, whereas either of these preoperative adjuvant therapies failed to ameliorate the prognosis of T₃ or T₄ stage patients. Therefore, systemic preoperative anticancer chemotherapies such as M-VAC are necessary to destroy “micrometastases” and to improve the prognosis of highly advanced bladder cancer.