Surgery Versus Perioperative Chemotherapy In Non Metastatic Muscle Invasive Bladder Carcinoma

Abstract

According to treatment guidelines of urinary bladder carcinoma, using Neoadjuvent chemotherapy followed by radical cystectomy is the standard treatment which improve overall survival and progression free survival. This study is conducted to compare effect of (1) neoagjuvent chemotherapy followed by radical cystectomy with (2) radical cystectomy followed by adjuvant chemotherapy, (3) Radical cystectomy only on OS and PFS. Patients and methods: This a retrospective study of all patients with urinary bladder cancer attended out patients at oncology , Beni seuf university hospital at period of 2013 to 2017 with follow up for 5 year.Results: In our study mean progression free survival was 24.6 months, longest time was among the patients underwent radical cystectomy followed by adjuvant chemotherapy with 27.8 months then neoadjuvant arm with 20.8 months then radical cystectomy only with 18.1 months with statistically significant difference between the three arms regarding the time spent till the occurrence of relapse (P-value<0.001).Mean over all survival was 27.1 months, the longest survival was among the patients underwent(1) radical cystectomy then adjuvant chemotherapy 28.1 months follow by patients who received(2) neoadjuvant with 23.1 months then(3) radical cystectomy with 20.7 months, there was a statistically significant difference between the three arms regarding the survival (P-value=0.003). Conclusion: Radical cystectomy followed by adjuvant treatment has the longest OS with 28.1 months and longest PFS with 27.8 months with statistical significant p value for OS 0.003* and for PFS <0.001** .

Keywords

• neoadjuvant
• adjuvant
• radical cystectomy
• pfs
• os