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Master Thesis

Evaluation des stratégies thérapeutiques pour la prise en charge des tumeurs de vessie infiltrant le muscle avec atteinte clinique des ganglions pelviens

Abstract : Introduction - The muscle-invasive bladder cancer (MIBC) with clinical evidence of regional lymph (cN+) represents a locally advanced disease, an aggressive malignancy with a high propensity for metastatic dissemination than the localized stages but which is not yet at a disseminated stage. This population of patients is heterogenous with non-standardized therapeutic management criteria and few data available in the literature. Objective -The objective of this study is to compare the carcinological results according to the therapeutic strategy adopted. Methods -This is a retrospective study, monocentric including all patients treated for MIBC cN+ between 2013 and 2018. Demographic characteristics, tumours and therapeutics were analyzed. Progression-free survival (PFS) and overall survival (OS) were compared against therapeutic strategies, after weighting on the inverse probability of treatment (IPTW). Results - A total of 54 patients were included, 41% cN1, 31% cN2 and 28 % cN3 and 39 patients were treated by surgery only or with peri-operative chemotherapy. After a median follow-up of 16 months, 35 patients (66 %) reoffended and 31 (57%) died. The PFS rate at 2 years was 31%. After adjustment according to the IPTW method, the use of surgery with or without chemotherapy was associated with a benefit in PFS (HR=0.33, IC 0.21-0.54) and OS (HR=0.54, IC 0.34-0.88). Conclusion - After treatment, 31% of patients with MIBC cN+ are potentially cured. Surgery with or without perioperative chemotherapy, appears to provide a benefit in PFS and OS compared to chemotherapy alone or radiation chemotherapy.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03464514
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Submitted on : Friday, December 3, 2021 - 11:50:53 AM
Last modification on : Friday, August 5, 2022 - 2:43:21 PM
Long-term archiving on: : Friday, March 4, 2022 - 6:57:16 PM

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  • HAL Id : dumas-03464514, version 1

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Lambert Gury. Evaluation des stratégies thérapeutiques pour la prise en charge des tumeurs de vessie infiltrant le muscle avec atteinte clinique des ganglions pelviens. Médecine humaine et pathologie. 2020. ⟨dumas-03464514⟩

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