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Hara T.,Yamaguchi University | Hara T.,Red Cross | Matsuyama H.,Yamaguchi University | Kamiryo Y.,Shimonoseki Saisekai Toyoura Hospital | And 16 more authors.
International Journal of Clinical Oncology | Year: 2016

Background: The standard of care for treatment of localized muscle-invasive bladder cancer (MIBC) is radical cystectomy (RC). The patient’s condition may affect management of MIBC, especially for elderly patients with more comorbid conditions and lower performance status. We retrospectively evaluated the association between clinicopathological data and outcomes for patients with bladder cancer (BCa) treated by RC. We particularly focused on elderly patients (age ≥75 years) with BCa. Methods: We enrolled 254 patients with BCa who underwent RC and urinary diversion with or without pelvic lymph node dissection. We assessed perioperative complications and clinicopathological data affecting overall survival (OS) after RC. Results: The incidence of complications was 34.3 %, and that of severe complications (Grade 3–5) was 16.5 %. The elderly group experienced more severe complications (P = 0.042). Median follow-up was 43.0 months (range 1.0–155.6). Five-year OS after RC was 62.7 %. OS after RC was no different for patients aged ≥75 and <75 years (P = 0.983). Multivariate analysis revealed that Eastern Cooperative Oncology Group performance status (ECOG PS) and hemoglobin (Hb) concentration were associated with all-cause mortality. Hb concentration of <12.6 g/dl was an independent predictor of a poor prognosis among elderly patients after RC for BCa. ECOG PS >1 tended to affect OS after RC in this group. Conclusion: ECOG PS and preoperative Hb concentration were useful for prediction of clinical outcome after RC for elderly patients. This information may aid decision-making in the treatment of elderly patients with MIBC. © 2015, Japan Society of Clinical Oncology. Source

Hayashi M.,Hikari Municipal Hikari General Hospital | Orita M.,Hikari Municipal Hikari General Hospital | Hironaka H.,Hikari Municipal Hikari General Hospital | Morita N.,Hikari Municipal Hikari General Hospital
Japanese Journal of Cancer and Chemotherapy | Year: 2014

Here we report a case of a 56-year-old woman who presented at our hospital with a chief complaint of a red lump in her right breast. Breast cancer (Rt C, T4bN0M0; ER [-], PgR [-], HER2: 3 [+]; stage III b) was diagnosed, and subsequent preoperative chemotherapy, mastectomy and axillary lymph node dissection were performed. Five months after surgery, bone metastasis in the thoracolumbar vertebrae developed and trastuzumab/zoledronic acid hydrate therapy was initiated. Four months after the therapy, tumor marker levels increased and docetaxel was added to the treatment regimen. Although the patient's condition temporarily improved, tumor marker levels increased again after 6 months, and the treatment regimen was switched to trastuzumab/nab- paclitaxel therapy. However, such regimen was discontinued owing to the development of liver metastasis, and lapatinib/capecitabine therapy was initiated. Two months after lapatinib/capecitabine therapy, tumor marker levels normalized and the liver metastasis markedly reduced. Side effects included paronychia (grade 3), which improved with dose reduction. The patient's therapy is being continued. Source

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