Japanese Journal of Clinical Oncology Advance Access originally published online on October 26, 2007
Japanese Journal of Clinical Oncology 2007 37(11):852-857; doi:10.1093/jjco/hym129
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© 2007 Foundation for Promotion of Cancer Research
Background Variables for the Patients with Invasive Bladder Cancer Suitable for Bladder-preserving Therapy
Department of Urology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba City, Ibaraki, Japan
For reprints and all correspondence: Hideyuki Akaza, Department of Urology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba City, Ibaraki 305-8575, Japan. E-mail: akazah{at}md.tsukuba.ac.jp
Received February 22, 2007; accepted June 3, 2007
Objective: The present study was undertaken to identify the patients suitable for bladder preservation by analysis of our data.
Methods: The subjects of this study were all 72 patients with T2–3N0M0 bladder cancer who underwent bladder-preserving therapy in our institute. The therapy involved intra-arterial chemotherapy with MTX and CDDP and concomitant radiotherapy.
Results: Of the evaluable 70 cases, complete response (CR) was confirmed in 57 cases (81.4%). Among 56 bladder preserved cases, 47 (83.9%) preserved their functioning bladder, and 9 underwent salvage radical cystectomy at the following period. The median follow-up was 45.3 months. The 5-year cause-specific survival rate was 81% and the 5-year overall survival rate was 66%. On the basis of the results of univariate analysis, variables contributing to CR were selected. In T2, tumor size of 
3 cm was scored 0 and >3 cm was scored 1, whereas single tumor was scored 0 and multiple were scored 1. In T3, tumor size of 3 cm was scored 0 and >3 cm was scored 1, whereas G2 was scored 0 and G3 scored 1. The CR rates were 93.8, 92.6, and 62.9% for total scores of 0, 1, and 2, respectively (P = 0.003; score 0 or 1 versus 2). The overall survival rate was significantly higher in the former group (P = 0.003).
Conclusion: Bladder-preserving therapy can be acceptable for cases of single T2N0M0 tumor with a size of 3 cm and for T3N0M0 cases with a tumor size of 3 cm.
Key Words: invasive bladder cancer • bladder preservation • chemotherapy • radiotherapy
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