Radical Cystectomy and Gemcitabine and Cisplatin Chemotherapy for Invasive Bladder Cancer

By GU Oncology Now Editors - Last Updated: January 12, 2022

A study explored the efficacy of radical cystectomy combined with gemcitabine and cisplatin (GC) chemotherapy in patients with bladder cancer, as well as the combination’s impact on adverse events after treatment. Lead author, Dewen Ban, and colleagues from the Department of Urology at the Affiliated Xinyang Hospital in China, found that radical cystectomy combined with GC appeared to reduce the incidence of adverse reactions and improve the five-year survival rate for patients with invasive bladder cancer.

According to the authors’ report, published in the American Journal of Translational Research, the combined treatment approach demonstrated a promising long-term efficicacy profile as well.

The study retrospectively reviewed data of a total of 120 patients with invasive bladder cancer who were admitted to the authors’ center. Patients were divided equally into either the experimental group, where they received the radical cystectomy and GC chemotherapy combination, or the control group, where they received bladder-preserving comprehensive treatment (transurethral bladder tumor resection, internal iliac artery infusion chemotherapy, and intravesical infusion chemotherapy). The primary outcomes compared between the two groups were short-term efficiency, adverse events, long-term treatment indicators, survival, surgical indicators, and quality of life.

The investigators reported that the groups had similar rates of objective remission and disease control (p > 0.05). Both groups presented with different levels of hematologic and non-hematologic toxicities during treatment, but no severe systemic organ toxicity was observed. Fewer patients in the experimental group developed anemia and fever (p < 0.05), and the incidences of recurrence, hydronephrosis, and metastasis were significantly lower compared to the control group (p < 0.05). The three-year survival rate in the experimental group was 86.7%, versus 75% for the control group, though the authors noted that the comparison was not over the threshold for significance (p > 0.05). The five-year survival rate, however, was significantly higher for the experimental group, at 70.0%, compared to the control group, at 51.7% (p < 0.001). The experimental group also demonstrated more favorable surgical indicators than the control group (p < 0.001), though both groups displayed similar quality-of-life outcomes after the five-year follow-up (p > 0.05).

The authors closed by spotlighting the need for new treatment methods for invasive bladder cancer that do not involve major surgical intervention or complications that may compromise the patients’ quality of life. According to their data, they posited that radical cystectomy and GC chemotherapy may be an effective treatment approach.