Interim Analysis: Trimodality Management of Urinary Bladder Cancer

This study included 16 patients with muscle invasive transitional cell carcinoma of the urinary bladder. All were males with median age of 60 years. Bilharzia! association was seen in 9 cases (56%). The majority had T2 and N0 disease (94% ). We attempted complete transuretheral resecetion of the tumour (TURT) in all cases, but it was possible in 9 cases (56% ). This was followed by 2 cycles of cisplatinum concurrent with pelvic radiation for 45GY. Interval cystoscopic assessment was done for each case. Eleven patients ( 69%) achieved complete histologic response and continued on further radiation of the bladder for 15GY with cisplatinum. The other 5 cases were referred for cystectomy, that was possible in 3 cases, the other 2 cases continued on the same scheme of chemoradiation. The treatment was reasonably tolerated by the majority of cases, vomiting was the commonest toxicity, observed in 13 patients (81 % ). The final outcome of our bladder-sparing protocol was 9 patients (56%) alive with preserved bladder. Incomplete TURT and replacing cisplatin by carboplatin, had significant poor impact on disease local control (p-value 0.01).