Clinicoepidemiological Study of Locally Advanced Bladder Cancer: single institution experience.

Abstract

Background : Bladder cancer is the ninth most prevalent disease worldwide, ranking 13 th in cancer mortality. Despite aggressive surgical treatments and systemic chemotherapy, patients with locally advanced bladder cancer (LABC) show poor prognosis. In patients with muscle-invasive bladder cancer (MIBC), perioperative chemotherapy adds just a small but significant absolute survival benefit to surgery alone. Aim: This study aims to assess the clinical-epidemiological characteristics of LABC and to assess the progression-free survival (PFS) and overall survival (OAS) of these patients upon different treatment plans. Material and Methods: This is a retrospective study that includes 135 patients presented with LABC to the Clinical Oncology and Nuclear Medicine Department at Mansoura university hospitals from January 2010 to November 2016. Our patient's ages ranged from 47 to 75 years old. The data on demographics and clinical outcomes were collected from the patients' medical records for descriptive studies. Results: The most common diagnoses stage in our patients were N0 (55.6%), followed by N2 (23.7%). As regards treatment modalities in our study, five groups of treatment approaches were scheduled to include 135 patients either treated by radical surgery (8.9 %), chemotherapy only (14.1%), radiotherapy (17.8%), concomitant chemoradiotherapy (11.1%), or downstaging chemotherapy followed by concomitant chemoradiotherapy (48.1%). Complete response (CR) was observed in 31.1% of the studied patients and the disease progression was documented in 11.1%. Conclusion: MIBC accounts for about 75% of bladder malignancies. However, radical cystectomy is the gold standard for achieving high OAS rates. Another option is to adopt tri-modality therapy to preserve the native bladder and achieve satisfactory OAS and data.