Bladder Cancer Therapy May Lower Disease-Free Survival

Chemotherapy, immunotherapy before radical cystectomy reduces survival

FRIDAY, July 13 (HealthDay News) -- Treatment of T1 high-grade bladder cancer with potentially bladder-sparing intravesical therapy (IVT), including chemotherapy and immunotherapy before progressing to radical cystectomy, may decrease disease-free survival, according to study findings in the July issue of the British Journal of Urology.

Erica H. Lambert, and colleagues from Columbia University Medical Center in New York City examined patterns of IVT use and survival in 104 patients with T1 high-grade transitional cell carcinoma of the bladder between 1990 and 2005. All patients underwent radical cystectomy and were divided into those who underwent the procedure before or after 1998.

The researchers found that significantly more patients underwent IVT before radical cystectomy after 1998 (26 percent prior to 1998 versus 57 percent after). The mean number of IVT courses per patient significantly increased from 0.53 to 1.2 after 1998. However, five-year disease-free survival significantly decreased after 1998 from 69.7 to 39.6 percent, according to the study.

"In very few other cancers has disease-free survival decreased over time," Lambert and colleagues conclude. "We postulate that the decrease in survival might be related to an increased use of IVT."

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