Clinical Efficacy Of Neoadjuvant Chemotherapy Combined With Transurethral Resection Of The Bladder Tumor Method Used For Muscle-invasive Bladder Cancer

Objective: To observe the effectiveness and prognosis of neoadjuvant chemotherapy and transurethral resection of the bladder tumor(TURBT)for muscle-invasive bladder cancer patients on T2~3N0M0 stage,and to explore the application value in the treatment of muscle-invasive bladder cancer by this treatment.Methods: We collected 61 patients with bladder cancer on T2~3N0M0 stage from the first affiliated hospital of Bengbu medical college since October 2011 to December 2014,retrospectively.According the patients’ choice and physical condition,we divided the patients into 2 groups.We selected 25 patients who chose neoadjuvant chemotherapy for 3 treatment periods and TURBT,which achieved tumor complete response after reevaluation of tumor stage as observation group;and took 36 patients received radical cystectomy and adjuvant chemotherapy as control group.We analized and evaluated the efficacy and safety of neoadjuvant chemotherapy and TURBT therapy and calculated the accumulative survival rate compared with the control group.Results: The maximum and minimum diameter of the tumor before neoadjuvant chemotherapy were 3.43±1.18 cm and 2.31±0.66 cm,respectively.The maximum and minimum diameter of the tumor after neoadjuvant chemotherapy were 2.74±1.13 cm and 1.58±0.38 cm,respectively.The main toxicitious reactions during neoadjuvant chemotherapy were myelosuppression and gastrointestinal toxicity which were relieved after symptomatic treatment and there were no serious toxicities reactions resulting chemotherapy interruption or death.All patients were followed up for 18~54 months.In observation group,7 patients had local recurrence and 2 patients had distant metastasis.Among the 7 patients of local recurrence,3 patients experienced superficial recurrence and 4 patients experienced invasive muscle recurrence.After follow-up,the 1,2,3-year accumulative overall survival rate in observation group were 95.8%,85.7% and 78.5%,respectively.The 1,2,3-year accumulative overall survival rate in control group were 97.2%,90.6% and 81.0%,respectively.The accumulative overall survival rate between the two groups were no statistically significant difference(P=0.720).Conclusion: Neoadjuvant chemotherapy can effectively reduce the tumor volume and stage,which is conducive to the complete resection of the tumor in the operation and improve the possibility of bladder preservation.Neoadjuvant chemotherapy combined with TURBT can obtain the similar curative effect compared with radical cystectomy and improve the quality of life significantly by bladder preservation.