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Kim, Yeo, and Lee: Safety of Adjuvant Chemotherapy after Orthotopic Bladder Substitution: Comparison to Ileal Conduit
Original Article
Korean Journal of Urology

Korean Journal of Urology 2007; 48(11): 1116-1120.

Published online: 30 November 2007

DOI: https://doi.org/10.4111/kju.2007.48.11.1116

Safety of Adjuvant Chemotherapy after Orthotopic Bladder Substitution: Comparison to Ileal Conduit

Kwang Taek Kim, Woon Geol Yeo, Eunsik Lee

Department of Urology, Seoul National University College of Medicine, Seoul, Korea.

Corresponding author (eslee@snu.ac.kr)

Received 14 August 2007       Accepted 2 October 2007

Copyright © 2007 The Korean Urological Association

Abstract

Purpose

Radical cystectomy with urinary tract reconstruction currently remains the standard treatment for invasive bladder cancer, and adjuvant chemotherapy is usually considered for patients with a clinical stage >T2 or nodal metastasis. The aim of this study was to assess the safety of adjuvant chemotherapy in patients with orthotopic bladder substitution in comparison to ileal conduit.

Materials and Methods

We retrospectively analyzed the patients who underwent radical cystectomy and urinary diversion between 1990 and 2005. The patients who underwent adjuvant chemotherapy were stratified into two groups: those who had orthotopic bladder substitution and those who had ileal conduit. The chemotherapy regimen, renal function change, complications from adjuvant chemotherapy and other relevant data were analyzed.

Results

Overall, 341 patients had radical cystectomy, 89 had adjuvant chemotherapy, 28 had orthotopic bladder substitution and 61 had ileal conduit. The patient characteristics, including age, stage and follow-up, were similar in both groups. In all, 42% of patients had grade 1 toxicity, 16% had grade 2, 14% had grade 3 and 0% had grade 4. No patients had serious organ toxicity and none died. There were no significant differences in the chemotherapy toxicity and renal function change among the two groups.

Conclusions

Adjuvant chemotherapy is safe and well tolerated by patients with either orthotopic bladder substitution or ileal conduit. There was no increased morbidity or mortality due to adjuvant chemotherapy in the patients who had orthotopic bladder substitution. Hence, orthotopic bladder substitution should not be denied to those patients with bladder cancer and who might require adjuvant chemotherapy.

Keywords: Adjuvant chemotherapy, Urinary diversion, Cystectomy, Bladder cancer

Figures and Tables

Fig. 1
The distribution of toxicity types (p=0.81).
kju-48-1116-g001
Fig. 2
The distribution of toxicity grades (p=0.90).
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Table 1
The patients' characteristics
kju-48-1116-i001

BMI: body mass index, GC: gemcitabine and cisplatin, MVAC: methotrexate, vinblastin, adriamycin and cisplatin

Table 2
Comparison of renal function between the two groups
kju-48-1116-i002
Table 3
Comparison of chemotherapy toxicity between the two groups
kju-48-1116-i003

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