Navigation Links
Improved radical surgery techniques provide positive outcomes for bladder cancer patients
Date:8/8/2011

Bladder cancer patients who have radical surgery at university hospitals can benefit from excellent local control of the disease, acceptable clinical outcomes and low death rates, according to research in the August issue of the urology journal BJUI.

Researchers studied 2,287 patients who had radical cystectomy surgery, where the bladder is removed, together with nearby tissue and organs as required. The surgery was performed at eight Canadian academic centres between 1998 and 2008.

The study found that there were three independent factors, apart from pathological stage at surgery, that influenced survival rates. Patients who smoked had lower survival rates, while patients who had pelvic lymphadenectomy - lymph nodes removed from the pelvic area - had higher survival rates, as did patients who received adjuvant chemotherapy, which aims to destroy microscopic cancer cells left after surgery.

However, the researchers found that neoadjuvant chemotherapy - which is often recommended prior to surgery to improve outcomes - tends to be under utilised for bladder cancer in Canada.

"Recent advances in combined radiation with chemotherapy have challenged the role of radical cystectomy (RC) with pelvic lymphadenectomy, which is used to treat muscle invasive and refractory non-muscle invasive bladder cancer" says co-author Dr Wassim Kassouf, from McGill University Health Centre, Quebec, Canada.

"These bladder-preservation strategies are potentially attractive in terms of health-related quality of life and cancer outcomes, but they only tend to work in highly selected patients.

"Advances in RC surgery have improved surgical care and techniques and reduced complications and mortality rates. The aim of our study was to evaluate a contemporary series of patients with bladder cancer to assess the clinical outcomes and identify any variables that affected their long-term health."

Key findings of the study included:

  • 79% of the patients were male, the median age was 68 and the average follow-up of live patients was just over 29 months. 66% reported a family history of tobacco smoking.

  • More than three-quarters of the patients had high-grade tumours. Pathological specimen examination revealed no evidence of cancer in 7% of patients, muscle invasive disease in 73% and positive nodal involvement in 25%.

  • Adjuvant chemotherapy was offered to 19% of patients and neoadjuvant chemotherapy to just over 3%.

  • All patients had previously undergone transurethral resection of bladder tumours and the median time from this to RC surgery was 49 days. This is similar to waiting times reported in international studies conducted in Sweden (49 days), the USA (42 days) and Germany (54 days).

  • The 30, 60 and 90-day death rates were 1.3%, 2.6% and 3.2% respectively. Cancer returned in 33% of patients within a median of 10 months. Local recurrence rates were 6% in the overall group and 4% in the organ-confirmed node-negative group.

  • The five-year overall, recurrence-free and cancer-specific survival rates were 57%, 48% and 67% respectively.

  • Multivariate analysis showed that lower pathological stage, negative surgical margins, receipt of adjuvant chemotherapy, performance of pelvic lymphadenectomy and an absence of smoking were associated with prolonged disease-specific and overall survival.

"Our study shows that very good results can be achieved when RC is performed at academic centres within a universal healthcare system and that it remains an effective clinical option for treating patients with bladder cancer" says Dr Kassouf.


'/>"/>

Contact: Annette Whibley
annette.wizard@gmail.com
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Clinic demonstrates improved quality of care resulting in cost savings for Medicare
2. New high-speed 3-D imaging system holds potential for improved cancer screening
3. New study may lead to quicker diagnosis, improved treatment for fatal lung disease
4. Amrubicin improved response rate and progression-free survival vs. topotecan in Phase III trial
5. Elderly Dutch lung patients survival improved by new treatment options between 2003-2009
6. High EGFR expression a predictor for improved survival with cetuximab plus chemotherapy
7. Improved stepladder design may decrease injuries
8. Drug shows improved kidney function for type 2 diabetics, UT Southwestern researchers report
9. Vaccine first to show improved survival rates for metastatic melanoma
10. ACSM: Stronger hips improved running mechanics, lessened knee pain
11. New research may lead to improved diagnosis of autism
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... June 27, 2016 , ... TherapySites, the ... affiliation with Tennessee Counseling Association. This new relationship allows TherapySites to ... Counseling Association, adding exclusive benefits and promotional offers. , "TCA is extremely excited ...
(Date:6/27/2016)... ... June 27, 2016 , ... TopConsumerReviews.com recently awarded their ... Eyeglasses . , Millions of individuals in the United States and Canada wear eyeglasses. ... way to both correct vision and make a fashion statement. Even celebrities use glasses ...
(Date:6/26/2016)... ... June 26, 2016 , ... Pixel Film Studios Released ProSlice Levels, ... editors can give their videos a whole new perspective by using the title ... Pixel Film Studios. , ProSlice Levels contains over 30 Different presets to choose ...
(Date:6/26/2016)... , ... June 26, 2016 , ... ... once they have been diagnosed with endometriosis. These women need a treatment plan ... require a comprehensive approach that can help for preservation of fertility and ultimately ...
(Date:6/25/2016)... ... June 25, 2016 , ... The temporary closing of Bruton Memorial Library on June ... , brings up a new, often overlooked aspect of head lice: the parasite’s ability to ... is not a common occurrence, but a necessary one in the event that lice have ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)...  In a startling report released today, National Safety Council ... a comprehensive, proven plan to eliminate prescription opioid overdoses. ... states are tackling the worst drug crisis in recorded U.S. history, ... Kentucky , New Mexico , ... the 28 failing states, three – Michigan , ...
(Date:6/23/2016)... -- Research and Markets has announced the addition ... - Forecast to 2022" report to their offering. ... to date financial data derived from varied research sources to ... potential impact on the market during the next five years, ... of sub markets, regional and country level analysis. The report ...
(Date:6/23/2016)... June 23, 2016 Research and Markets ... Issue 52" report to their offering. ... treatment creates a favourable commercial environment for MedImmune to enter. ... base that will serve to drive considerable growth for effective ... serve to cap sales considerably, but development is still in ...
Breaking Medicine Technology: