Controversies in the treatment of invasive urothelial carcinoma: a case report and review of the literature

BMC Urology

Case Report

Carlos Camps¹  José Luis González-Larriba²  Pablo Maroto³  Daniel Castellano⁴  Emilio Esteban⁵  Javier Cassinello⁶  Miguel Angel Climent⁷  Vicente Guillem⁸ 

[1] Consorcio Hospital General Universitario de Valencia and Universitat de Valencia, Valencia, Spain;Hospital Clinico San Carlos, Madrid, Spain;Hospital Sant Pau, Barcelona, Spain;Hospital Universitario 12 de Octubre, Madrid, Spain;Hospital Universitario Central de Asturias, Asturias, Spain;Hospital Universitario de Guadalajara, Guadalajara, Spain;Instituto Valenciano de Oncología, Valencia, Spain;Instituto Valenciano de Oncología, Valencia, Spain;Medical Oncology Department, Instituto Valenciano de Oncologia, C/Prof. Beltrán Báguena, 8-11 46009, Valencia, Spain;

关键词: Muscle-invasive bladder cancer;    Urothelial carcinoma;    Neoadjuvant chemotherapy;    Adjuvant chemotherapy;    Unfit;   

DOI  :  10.1186/s12894-015-0008-7

 received in 2014-05-14, accepted in 2015-02-16,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundMore than 429,000 patients worldwide are diagnosed with bladder cancer each year and muscle-invasive bladder cancer has an especially poor outcome. The median age at diagnosis is over 70 years, and many patients also have a substantial number of age-associated impairments that need to be considered when planning therapeutic interventions.Case presentationHere, we report the case of a 63-year-old man with a cT3b urothelial carcinoma which was surgically removed. No neoadjuvant or adjuvant chemotherapy was administered. After 18 months a lung metastasis was confirmed and resected but no chemotherapy was given after surgery. Twelve months later, the patient relapsed and was treated with a combination of gemcitabine and cisplatin and after a decline in renal function the treatment was changed to a combination of carboplatin and gemcitabine which resulted in a partial response which lasted 8 months. Following this vinflunine was administered as a second line treatment.Here we review the evidence available in the literature regarding the suitability of different treatment options for managing muscle-invasive bladder cancer at each step of the case presentation.ConclusionBladder cancer treatment requires a multidisciplinary approach. Although, depending on the clinical characteristics of the patient, there are some controversial points in the management of this pathology we hope that the scientific data and the clinical trials reviewed in this case report, can help to guide physicians to make more rational decisions regarding the management of these patients.

【 授权许可】

CC BY   
© Guillem et al.; licensee BioMed Central. 2015