Report of a participant of the XI Congress of the Russian Аssociation of Оncological Urology. Bladder cancer: what’s new in 2016

Bladder cancer (BC) remains one of the most common oncourological diseases. Five-year survival for patients with Т3–4N0M0 stage remains at the level of 33–52 %. Average life span for patients with metastases is 9–26 months. Changes in application of immediate adjuvant therapy for non-muscle invasive BC were made, as well as in selection of surgical treatment: open or laparoscopic cystectomy. Results of cystectomy depending on pathohistological tumor structure were studied. Lymph nodes were more frequently affected with urothelial cancer with squamous metaplasia. The role of the number of metastatic lymph nodes after radical cystectomy in determination of treatment strategy is still open for discussion. It was shown that even 1 metastatic lymph node reduces survival by 30 % and requires adjuvant chemotherapy. Blood transfusion during radical cystectomy negatively affects immune system functioning, increases frequency of infectious complications (sepsis, pneumonia, abscess). Metastasectomy performed in cases with positive response to chemotherapy can increase patients’ life span. Median survival was 35.4 months after lesion discovery and 34.3 months after metastasectomy. Efficiency and tolerability profiles for 2 chemotherapy regimens were studied: vinflunine + gemcitabine and vinflunine + carboplatin. Comparative analysis has shown that the regimes are equally effective, no significant differences were observed. New anti-tumor drugs for patients with metastatic BC are being actively researched. In 2016 the American Society of Clinical Oncology (ASCO) presented data on atezolizumab. The drug was injected intravenously at doses 1200 mg/m23 times a week. This regimen was effective both in a patient group receiving cisplatin and in a patient group untreated with this drug. In May of 2016 atezolizumab was registered by the Food and Drug Administration (FDA) for BC treatment on a priority basis.