Abstract 205P
Background
The standard care for muscle invasive bladder carcinoma (MIBC) in the United States for a long time was radical cystectomy where as in Europe, it is radical radiotherapy or multidrug regimen neoadjuvant chemotherapy followed by radiotherapy. In spite of the importance in terms of incidence, prognosis and cost, bladder cancer research remains significantly underfunded so the studies and data on organ preservation in MIBC in India are less explored.
Methods
We analyzed the data of 30 patients of MIBC from 2016-2018 who underwent primary transurethral resection of bladder tumour (TURBT) followed by IMRT with 64.8 Gy and weekly cisplatin at dose of 40 mg/ m2 with median follow up of 10 months. The role of various factors like tumour stage, histopathology, grade, complete TURBT, obstructive uropathy on locoregional response and disease free survival was evaluated. Local reactions evaluated using CTCAE criteria version 5.0. Statistical analysis was done using SPSS version 23.0.
Results
Table: 205P
Demographic and disease characteristics
Age | Median – 68 Yrs Range – 52 - 80 Yrs |
Sex | Male – 86.7% (n=26) Female – 13.3% (n=4) |
Turbt | Complete – 33.3% (n=10) Incomplete – 66.7% (n=20) |
Histopathology | Transitional – 86.6%(n=26) Squamous – 6.7% (n=2) Adeno CA – 6.7% (n=2) |
Grade | Grade I – 6.7% (n=2) Grade II – 26.6% (n=8) Grade III - 66.7% (n=20) |
Tumour Stage | T2 – 53.3 % (n=16) T3 – 33.3 % (n=10) T4 – 13.4 % (n=4) |
Obstructive Uropathy | Present – 33.3 % (n=10) Absent – 66.7% (n=20) |
Locoregional Response | Complete – 73.3% (n=22) Partial – 20% (n=6) Progression – 6.7% (n=2) |
After the treatment, the complete locoregional response (LRR) was 73.3%. Early (T2 stage) tumours (p= 0.043) and patients without obstructive uropathy (p= 0.039) have shown significant LRR. Patients with complete TURBT, Low grade tumours shown increased response though statistically not significant. The overall disease free survival in this study for the preserved bladder patients is 53.3%. Patients without obstructive uropathy have shown significant DFS of 70% (p=0.026). Improved DFS of patients with T2 stage tumours (75%), complete TURBT (60%), low grade tumours was observed though statistically not significant. GU toxicities like dysuria, burning micturition in 40% of patients, increased frequency of micturition in 20% of patients, gastro intestinal toxicities like constipation (40%), pain abdomen (6.7%) were observed during followup and all these are grade I,II and managed well with supportive treatment.
Conclusions
Bladder preservation in more than 70% of patients in this study supports the general concept of organ sparing treatment in oncology. The high response rate and DFS were observed in south Indians with complete TURBT, early stage tumours, no obstructive uropathy and low grade tumours. The genito urinary & gastro intestinal toxicities are comparatively less, probably in view of using IMRT technique and single agent cisplatin.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Dr Himani Manchala.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
286P - Improved diagnostic accuracy on MR imaging in post-surgical recurrent head and neck SCC lesions using decision tree classification system
Presenter: Ankush Jajodia
Session: e-Poster Display Session
287P - Establishment of nasopharyngeal carcinoma organoid culture system and preliminary exploration of drug sensitivity test in vitro
Presenter: Wang Wen
Session: e-Poster Display Session
288P - Application of volumetric modulated arc therapy (VMAT) in head and neck cancers: 5-year single institutional experience
Presenter: Hiep Doan
Session: e-Poster Display Session
289P - Radiotherapy in advanced nasopharyngeal carcinoma
Presenter: Chih Kiang Tan
Session: e-Poster Display Session
292P - Shared decision-making at the cancer institute adult outpatient clinics of a tertiary hospital in the Philippines: A cross sectional study
Presenter: Marvin Jonne Mendoza
Session: e-Poster Display Session
293P - Prolonged release (PR) oxycodone/naloxone (OXN) for cancer pain (CP) & its impact on bowel function, safety & quality of life (QoL): Systematic review
Presenter: Sam Hjelmeland Ahmedzai
Session: e-Poster Display Session
294P - Interventional pain treatment in patients with pain syndrome in advanced tumours of small pelvis
Presenter: Yakhyo Ziyaev
Session: e-Poster Display Session
295P - Assessment of the impact of palliative care on the quality of life in advanced non-small cell lung cancer patients
Presenter: Sabin Katpattil
Session: e-Poster Display Session
296P - Outcomes of repeat transhepatic percutaneous biliary drainage in patients presenting with recurrent malignant biliary stricture
Presenter: Deevia Hanji
Session: e-Poster Display Session
297P - Factors affecting duration of admission in the palliative medicine ward of a tertiary cancer hospital: A pilot, investigator initiated, review of services
Presenter: Rahul D. Arora
Session: e-Poster Display Session