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Aim:In this study our aim is to evaluate the benefit of neoadjuvant chemotherapy (NAC) in high risk NMIBC in preventing disease recurrence and progression while improving overall survival (OS).Patients and Methods:This prospective study included 33 patients with a pathologically confirmed NMIBC(T1) at the time of Transurethral resection of a bladder tumor (TURBT) with one or more high risk features (HRFs) during the period (2019- 2022),at Assiut University Hospital. All patients received 3 cycles neoadjuvant chemotherapy (cisplatin-gemcitabine) every 3 weeks and assessment of response was done by pelviabdomen Multi slice-CT and cystoscopy then TURBT and kept under follow up every 3 months by cystoscopy in the first 2 years. Results: A complete response (CR) was observed in 82% of the patients and disease progression (DP) to in 18% of the patients. Two year OS rate was 79% and two year disease free rate survival(DFS) was 76%.In Univariate regression t Patients with one risk features were 7 time more in 2 years DFS than patients with ≥ 2 risk features (OR= 6.90), Patients with no foci of squamous differentiation were 5 time more in 2 years DFS than patients with foci of squamous differentiation (OR= 5.25) and all factors were significant. In a multivariate regression model the significant variable only was Patients with no foci of squamous differentiation(OR= 6.92).Conclusion:NAC seems to have promising results in treatment of patients with one HRF NMIBC and a further investigation needed to determine the role of multimodal therapy in patients with two or more high risk feature NMIBC
DOI
10.21608/bfsa.2023.300947
Keywords
Neoadjuvant chemotherapy, Non Muscle Invasive Bladder Cancer, Transurethral resection of a bladder tumor, Overall survival, Disease free survival
Authors
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Department Clinical Ocology, Assiut University Hospital, Assiut, Egypt
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Department Clinical Ocology, Assiut University Hospital, Assiut, Egypt
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Department Urology, Assiut University Hospital, Assiut, Egypt
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Assiut University hospital
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hebashiha3@gmail.com
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Department Clinical Ocology, Assiut University Hospital, Assiut, Egypt
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https://bpsa.journals.ekb.eg/article_300947.html
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https://bpsa.journals.ekb.eg/service?article_code=300947
Publication Title
Bulletin of Pharmaceutical Sciences Assiut University
Publication Link
https://bpsa.journals.ekb.eg/
MainTitle
ROLE OF NEOADJUVANT CHEMOTHERAPY IN THE CONSERVATIVE MANAGEMENT OF NON-MUSCLE INVASIVE BLADDER CANCER (NMIBC) T1