[Intraarterial chemotherapy for patients with invasive bladder cancer--clinical effects and preliminary results in bladder preservation].

Preoperative intraarterial chemotherapy including cisplatin, etoposide and adriamycin was performed for 16 patients with invasive bladder cancer between April, 1989 and September, 1993. Of 16 patients, radical cystectomy was done in 12 patients and the bladder was preserved by a transurethral resection in 4. Of 12 patients treated with cystectomy, complete response was achieved in 2 cases and partial response in 4 (response rate: 50%). Pathological evaluation of resected specimens revealed significant downstage of the tumors in 8 of 12 patients (67%). At follow-up 4 patients had recurrent and/or distant metastasis. Three of these four patients died of cancer progression and one survived with cancer. Of 4 patients with preserved bladder, complete response was achieved in one case and partial response in 3. Pathological specimens evaluated by transurethral resection showed significant downstage of tumors in all cases. One patient had an invasive, recurrent tumor in the preserved bladder and was treated with radical cystectomy 6 months after initiation of the therapy. All patients tolerated the treatment well. Intraarterial chemotherapy seems to be effective for invasive bladder cancer, but the true success of bladder-preserving treatment by a transurethral resection, chemotherapy and other therapy will require further study.