Tetramodal Bladder-Preservation Therapy Incorporating Induction Chemoradiotherapy and Consolidative Partial Cystectomy with Pelvic Lymphnode Dissection for Muscle-Invasive Bladder Cancer: Long-term Oncologic Outcomes of 201 Patients

You have accessJournal of UrologyBladder Cancer: Invasive III (PD34)1 May 2024PD34-07 LONG-TERM ONCOLOGIC OUTCOMES OF TETRAMODAL BLADDER-PRESERVATION THERAPY INCORPORATING INDUCTION CHEMORADIOTHERAPY AND CONSOLIDATIVE PARTIAL CYSTECTOMY WITH PELVIC LYMPHNODE DISSECTION FOR MUSCLE-INVASIVE BLADDER CANCER Hajime Tanaka, Motohiro Fujiwara, Akira Hasegawa, Hiroki Tanaka, Kotaro Suzuki, Tomoki Kimura, Rikuto Yasujima, Tsubasa Ito, Riko Ikeda, Shunya Matsumoto, Kasumi Yoshitomi, Masaki Kobayashi, Yuki Nakamura, Bo Fan, Wei Chen, Yudai Ishikawa, Shohei Fukuda, Yuma Waseda, Soichiro Yoshida, Ryoichi Yoshimura, Kazunori Kihara, and Yasuhisa Fujii Hajime TanakaHajime Tanaka , Motohiro FujiwaraMotohiro Fujiwara , Akira HasegawaAkira Hasegawa , Hiroki TanakaHiroki Tanaka , Kotaro SuzukiKotaro Suzuki , Tomoki KimuraTomoki Kimura , Rikuto YasujimaRikuto Yasujima , Tsubasa ItoTsubasa Ito , Riko IkedaRiko Ikeda , Shunya MatsumotoShunya Matsumoto , Kasumi YoshitomiKasumi Yoshitomi , Masaki KobayashiMasaki Kobayashi , Yuki NakamuraYuki Nakamura , Bo FanBo Fan , Wei ChenWei Chen , Yudai IshikawaYudai Ishikawa , Shohei FukudaShohei Fukuda , Yuma WasedaYuma Waseda , Soichiro YoshidaSoichiro Yoshida , Ryoichi YoshimuraRyoichi Yoshimura , Kazunori KiharaKazunori Kihara , and Yasuhisa FujiiYasuhisa Fujii View All Author Informationhttps://doi.org/10.1097/01.JU.0001008768.36634.79.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Chemoradiation (CRT)-based bladder-preservation therapy is currently acknowledged as a curative treatment option for muscle-invasive bladder cancer (MIBC). However, one of the major concerns is the risk of MIBC recurrence, which may be originated from latent cancer cells remaining after CRT. We developed tetramodal bladder-preservation therapy (TeMT) incorporating induction CRT and consolidative partial cystectomy (PC) with pelvic lymphnode dissection (PLND). This study assessed the long-term oncologic outcomes of MIBC patients treated with TeMT. METHODS: Following the institutional review board approval (# M2000-453), we prospectively enrolled 201 patients with N0M0 MIBC between 1997 and 2020. All the patients met the inclusion criteria for the enrollment (Figure 1). After maximal transurethral resection and induction CRT, patients who had complete remission of cancer or small amount of microscopic Ta/is cancer remaining at the original tumor site underwent consolidative PC with PLND and achieved bladder preservation; salvage radical cystectomy was offered to the other patients. RESULTS: The median age was 69, and 157 patients (78%) were male. Overall 171 patients (85%) sufficiently responded to induction CRT. Among them, 148 (74%) underwent consolidative PC according to the protocol. Pathological examination of the PC specimens revealed that residual bladder cancer in 15 patients (10%) including 3 (2.0%)/2 (1.4%)/10 (6.8%) showing ypTis/T1/T2-3, respectively and lymphnode metastasis in 4 (2.7%) were surgically removed in this surgery. During the median follow up of 6.2 years (IQR: 4.1-9.8), 31 (15%) in the intent-to-treat (ITT) patients and 13 (8.8%) in those who underwent PC died of bladder cancer. 5/10 year-cancer-specific survival was 85%/82% in ITT patients, respectively, and 92%/90% in patients undergoing PC, respectively. The cumulative incidences of MIBC recurrence after PC were 6.0% at 5 years and 8.8% at 10 years. CONCLUSIONS: TeMT protocol incorporating induction CRT and consolidative PC with PLND yielded favorable long-term oncologic outcomes for optimally selected patients with MIBC. Consolidative PC may contribute to decreasing the risk of MIBC recurrence. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e721 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Hajime Tanaka More articles by this author Motohiro Fujiwara More articles by this author Akira Hasegawa More articles by this author Hiroki Tanaka More articles by this author Kotaro Suzuki More articles by this author Tomoki Kimura More articles by this author Rikuto Yasujima More articles by this author Tsubasa Ito More articles by this author Riko Ikeda More articles by this author Shunya Matsumoto More articles by this author Kasumi Yoshitomi More articles by this author Masaki Kobayashi More articles by this author Yuki Nakamura More articles by this author Bo Fan More articles by this author Wei Chen More articles by this author Yudai Ishikawa More articles by this author Shohei Fukuda More articles by this author Yuma Waseda More articles by this author Soichiro Yoshida More articles by this author Ryoichi Yoshimura More articles by this author Kazunori Kihara More articles by this author Yasuhisa Fujii More articles by this author Expand All Advertisement PDF downloadLoading ...