A three-mode organ-preserving therapy in modern algorithm of treatment of primary low-differentiated musculo-invasive cancer of the bladder
Objective. To determine a modern position of a three-mode organ-preserving therapy (THMTH) in treatment of primary low-differentiated (G3) cancer of thebladder (BC).
Materials and methods. Retrospective data from medical cards were analyzed in 346 patients, suffering primary G3 cancer of the bladder, who were operated in 2004 - 2017 yrs, Among them there were the bladder cancer clinical stage, procedures of treatment - surgical (radical cystectomy/resection), distant radiation therapy (DRTH), polychemotherapy (PCHTH), and survival of the patients. In 13 patients further surgical treatment was not performed, their treatment was restricted by the bladder biopsy because of severe comorbidity presented. These patients were excluded from the analysis.
Results. Organ-preserving operation was conducted in 224 (67%) patients. Total mortality have constituted 63%. Postoperative therapy (DRTH or PCHTH) have obtained 54 (16.2%) patients, of them 44 (81.5%) - DRTH, 10 (18.5%) - PCHTH. Combination of PCHTH and DRTH was not used. General mortality in the patients, who obtained DRTH or PCHTH, have constituted 80%, average duration of survival - 17 and 8 mo, accordingly.
Conclusion. Organ-preserving surgical tactics in modern treatment of primary G3 cancer of the bladder occupies prominent position: 67% of all the patients were operated, using resection. Postoperative PCHTH or DRTH was conducted in 16.2% patients in monoregime mainly with palliative objective, what did not promoted a durable survival (mortality have constituted 80%).
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