Prognostic value of the response to induction chemotherapy in patients with locally advanced inoperable urothelial cancer

JW de Beukelaar a,TA Splinter MD, PhD a, CC vd Rijt MD, PhD a, PI Schmitz PhD b, WJ Kirkels MD, PhD c

Departments ofa Medical Oncology, b Biostatistics,and c Urology of the Erasmus University Medical Centre Rotterdam, the Netherlands

Purpose: The aim of this retrospective study was to assess different subgroups with respect to prognosis and survival in 45 pts with locally advanced inoperable urothelial cancer treated with cisplatin-based chemotherapy. Materials & Methods: 45 pts, KPS 80-100%, histologically proven urothelial cancer, 9 staged T4N0M0, 25 pts T3-4N+M0, 11 pts TxN+M0, were treated with cisplatin-based chemotherapy. Response was evaluated by CT-scan every 2 cycles and by TUR-biopsy after 4 & 6 cycles. CR and PR = responders, SD and PD = non-responders. Results: 20 clinical responders and 25 clinical non-responders. Med follow-up of pts alive is 49,5 mths, med overall survival 20 mths and 4 yrs overall survival 25%. In responders med survival is not reached, 4 yrs survival 54%. Non-responders had a med survival of 16 mths, 4 yrs survival 0%. Conclusions: In patients with locally advanced urothelial cancer treated with chemotherapy, the distinction in responders and non-responders is highly significant for survival. Such prognostic value in vivo, especially for non-responders, should be predicted by molecular biological characteristics.

KEY WORDS: survival, prognostic factors, urologic cancer.

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Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Paris, France; February 9 - 12, 2002; in the section on Prognostic Markers.