Long Term Progression Free Survival Achieved by Maintenance “Second–Line” Polychemotherapy with Gemcitabine/Paclitaxel in Metastatic Urothelial Cancer of the Renal Pelvis—A Case Report

Moderate activity of systemic chemotherapy for advanced urothelial cancer has been reported for more than 30 years. Only with the advent of potent combination therapy clinically significant response rates as well as prolonged survival were documented. The therapeutic effect of a “second-line” polychemotherapy in metastatic upper tract urothelial cancer is largely unknown caused by the small number of cases and poor prognosis. We report an interesting case of a 59-year-old man suffering from urothelial cancer of the renal pelvis with pulmonary, lymphogenic and bone metastases who showed an unexpected response to a “second-line”chemotherapy after only 2 treatment cycles of Gemcitabine/Paclitaxel (partial remission) after 24 treatment cycles Gemcitabine / Cisplatin in “stable disease” and progression between the treatment intervals. We performed maintenance “second-line” therapy for 24 cycles and the patient showed a remarkable persisting response 54 months after operation.