Clinical Evaluation Of Neoadjuvant Chemotherapy In 8 Patients With Invasive Bladder Cancer

ObjectiveTo investigate the curative effect of neoadjuvant chemotherapy with gemcitabine and cisplatin(GC)in the treatment of invasive bladder cancer,in order to provide new ideas for the future diagnosis and treatment of invasive bladder cancer.MethodsIn June 2016,our hospital began to select the patients with multiple lesions on the bladder walls under cystoscope,pathological biopsy results which were invasive bladder cancer and the will to bladder preservation.Gave the neoadjuvant chemotherapy(gemcitabine plus cisplatin)to these patients,then evaluate the patients' disease situation to choose the best operation program for them,which was beneficial to improve the patients' life quality after surgery.To assess the evaluation of neoadjuvant chemotherapy,the value of bladder tumors' diameter reduced,the tumor stage and histological grade decreased or not,the pathological level of tumor decreased or not,which can be observed in the short term.On the other hand,the rate of tumor recurrence,the five-year survival rate and the disease-free survival rate can be observed to assess the long-term evaluation of neoadjuvant chemotherapy.There are 8 males,aged between 50 to 71 years with the average age of 61 years,underwent 2?4 neoadjuvant chemotherapy(GC regimen)for neoadjuvant chemotherapy.5 cases underwent TURBt,while 2 cases underwent open under partial cystectomy,1 patient gave up the surgery.ResultsAfter 2-4 times of neoadjuvant chemotherapy(GC),at the value of bladder tumors' diameter reduced,7 patients achieved partial remission(66.7%,60%,50%,62.5%,50%,65%,100%),while 1 patient did not(0%).There were 7 patients with bladder tumor stage decreased respectively from T2bNoM0?T2bN0M0?T3N0M0?T2bN0M0?T3N0M0?T3N0M0?T2bN0M0 to T1N0M0?T1N0M0?T2aN0M0?T2aN0M0?T2bN0M0?T2bN0M0?T0N0M0,and one without change.What's more,2 patients' pathological levels of tumors were decreased,while 5 patients' pathological levels of tumors were not.1 patient didn't have an operation or the surgical specimens.5 patients underwent transurethral resection of bladder tumor(TURBt),2 patients underwent partial cystectomy because of the specific location of tumor.However 1 patient with curative effect in the treatment of excessive demands underwent total cystectomy refused surgery.The results showed that there was one patient recrudesced in 3.3 months.ConclusionNeoadjuvant chemotherapy(GC regimen)can significantly reduce the tumor diameter,reduce tumor stage and pathological grade of the patients with the bladder tumor,which is T2N0M0?T4aN0M0.Thus it can provide a strong condition for bladder preserving operation.And according to the pathological results of the surgical specimens,we can give some postoperative adjuvant therapy including standardized bladder perfusion chemotherapy.Most patients can obtain disease-free survival in the short term,but the rate of long-term survival needs more further follow-up study.In order to evaluate the clinical value of neoadjuvant chemotherapy in the treatment of invasive bladder cancer at high level,we need to prove it from the perspective of evidence-based medicine.