COMPLICATIONS OF RADICAL CYSTECTOMY - IMPACT OF THE TIMING OF PERIOPERATIVE CHEMOTHERAPY

Objectives. To evaluate the impact of timing of perioperative chemothe rapy on morbidity of radical cystectomy in patients with bladder cance r. Methods. We compared the complications in patients randomized to ne oadjuvant (n = 55) or adjuvant (n = 49) MVAC (methotrexate, vinblastin e, doxorubicin,and cisplatin) chemotherapy. Results. In the 95 patient s who underwent cystectomy, there were no significant differences in t reatment compliance, surgical parameters, or postoperative recovery be tween the two groups. In patients who received neoadjuvant chemotherap y, there were more complications, and there was one perioperative deat h; however, these differences were not significant. The neoadjuvant gr oup took longer to complete therapy (P <0.001). Nine patients (3 neoad juvant, 6 adjuvant) did not undergo cystectomy on time. Conclusions. C ystectomy following neoadjuvant MVAC chemotherapy is feasible. We were unable to demonstrate any difference between neoadjuvant and adjuvant chemotherapy in mortality, morbidity, or post-operative clinical cour se.