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• W4230484847 abstract "You have accessJournal of UrologyBladder Cancer: Staging1 Apr 20111906 NEOADJUVANT SYSTEMIC THERAPY VS EARLY CYSTECTOMY? SINGLE CENTER ANALYSIS OF OUTCOMES FOLLOWING THERAPY FOR PATIENTS WITH CLINICALLY LOCALIZED MICROPAPILLARY UROTHELIAL CARCINOMA OF THE BLADDER Ranko Miocinovic, Islam A. Ghoneim, Andrew J. Stephenson, Jorge A. Garcia, Michael C. Gong, Steven C. Campbell, Donna E. Hansel, and Amr Fergany Ranko MiocinovicRanko Miocinovic Cleveland, OH More articles by this author , Islam A. GhoneimIslam A. Ghoneim Cleveland, OH More articles by this author , Andrew J. StephensonAndrew J. Stephenson Cleveland, OH More articles by this author , Jorge A. GarciaJorge A. Garcia Cleveland, OH More articles by this author , Michael C. GongMichael C. Gong Cleveland, OH More articles by this author , Steven C. CampbellSteven C. Campbell Cleveland, OH More articles by this author , Donna E. HanselDonna E. Hansel Cleveland, OH More articles by this author , and Amr FerganyAmr Fergany Cleveland, OH More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2030AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Micropapillary bladder cancer (MPBC) is a rare variant of urothelial carcinoma (UC) with an aggressive clinical behavior. Radical cystectomy is considered to be the standard approach for treatment of patients with localized disease, however, the role of perioperative systemic therapy is poorly defined. We analyzed treatment outcomes of patients with MPBC. METHODS A retrospective review identified 38 consecutive patients treated at our institution for MPBC between years 2000 and 2010. Patients were analyzed for pre- and post-operative clinicopathological features, treatment course, and cancer specific survival. RESULTS The median follow-up of surviving patients after cystectomy was 17 months (range, 2–75). At initial transurethral biopsy (TURB) 28 (74%) patients had clinical stage ≤ cT2N0. In this group, 26 of 28 (93%) were upstaged to non-organ-confined and/or lymph node-positive disease. Overall, 32 (86%) patients had evidence of lymph node metastasis on final pathology. Only 2 of 37 evaluable patients had organ-confined and node-negative disease at cystectomy. All patients with cTis-T1 who received initial bladder-sparing therapy with BCG had pathologically advanced disease at cystectomy. All 15 patients who received perioperative cisplatin-based chemotherapy died from metastatic disease. Five-year overall survival was 40% (95% CI: 16–64). CONCLUSIONS MPBC is an aggressive disease with high likelihood of regional lymph node metastasis at initial presentation. Although radical cystectomy plays a critical role in patient management, systemic neoadjuvant chemotherapy may be a more appropriate strategy than immediate cystectomy. In view of poor response to current chemotherapy agents, development of new and effective drugs for this subset of patients may be needed. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e762 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ranko Miocinovic Cleveland, OH More articles by this author Islam A. Ghoneim Cleveland, OH More articles by this author Andrew J. Stephenson Cleveland, OH More articles by this author Jorge A. Garcia Cleveland, OH More articles by this author Michael C. Gong Cleveland, OH More articles by this author Steven C. Campbell Cleveland, OH More articles by this author Donna E. Hansel Cleveland, OH More articles by this author Amr Fergany Cleveland, OH More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W4230484847 title "1906 NEOADJUVANT SYSTEMIC THERAPY VS EARLY CYSTECTOMY? SINGLE CENTER ANALYSIS OF OUTCOMES FOLLOWING THERAPY FOR PATIENTS WITH CLINICALLY LOCALIZED MICROPAPILLARY UROTHELIAL CARCINOMA OF THE BLADDER" @default.
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