Respuesta a la quimioterapia adyuvante post-cistectomía en pacientes con tumor de vejiga infiltrante: Análisis de 397 casos

objectives: to define the usefulness of adjuvant chemotherapy in patients with pt2, pn0, pt3-4, pn0 and pn+ disease. methods: retrospective analysis of 397 patients with transitional bladder cancer who underwent radical cystectomy between 1986 and 2005. adjuvant chemotherapy was administered to 40.2% of patients. three cycles of adjuvant mvac (methotrexate, vinblastine, adriamycin and cisplatin) were given. results: in patients with pt3, pn0 (p=0.04) and/or n+ stages (p=0.001), adjuvant chemotherapy significantly improved cancer-specific survival, which did not occur in pt2n0 (p=0.9) and pt4, pn0 (p=0.6) patients. in the univariate analysis, adjuvant chemotherapy was significantly associated with a lower cancer-specific survival rate (rr 1.452 95% ci: 1.028- 2.057 p= 0.03), while the multivariate analysis showed a trend (rr: 0.651 95% ci 0.398-1.065, p=0.08) towards a decrease in cancer-specific mortality. conclusions: although adjuvant chemotherapy was not shown to improve survival in patients with pt0-2, pn0 and pt4, pn0 disease, it did increase survival in those with extravesical disease, pathological state t3, pn0 and/or pn+. considering its tendency to improve cancer-specific survival, adjuvant chemotherapy may be considered as a "protective factor" (rr=0.651, p=0.08).