Biomedical subjects

M Hornák

Publications and source records attributed to M Hornák.

At least 19 recordsLinked to original sources

PubMed2004

[Biologic characteristics of invasive bladder cancer: is there a difference between primary and progressive tumours?].

OBJECTIVE: In most muscle-invasive bladder cancer muscle invasion is present at the time of first diagnosis (primary tumours), in the rest of the patients muscle invasion is caused by progression of superficial tumours (progressive tumours). The aim of study is to determine whether a difference in natural history is between primary and progressive tumours. MATERIAL AND METHODS: In 1997-2001 we treated 278 patients with bladder cancer, 167 (60.1%) patients had superficial tumours and 111 patients had invasive tumours. At the time of diagnosis muscle invasion of the bladder was present in 90 (81.1%) patients, in 21 (18.9%) invasion was formed by progression of superficial tumours. The retrospective study evaluated and compared characteristics of patients (incl. survival) and tumours. Statistical significance was calculated by the chi2 test. RESULTS: A mean age of patients with primary tumours was 65.2 +/- 10.5 years, compared with mean age of 61.7 +/- 12.6 years of patients with progressive tumours. Gender--male:female ratio was 3.1:1 in primary tumours, as opposed to 4.2:1 in progressive. Progression of superficial tumours was noted on average within 35.4 months (range of 7-115). Within one year died 46 out of 90 (51.1%) patients with primary tumours and 11 out of 21 (52.4%) patients with progressive tumours. Three years survived 14 out of 61 (23%) patients with primary tumours and two out of 13 (15.4%) with progressive tumours. CONCLUSIONS: Prognosis of patients with progressive tumours is worse than prognosis of patients with primary invasive tumours. It is vital to detect superficial tumours in their pre-invasive stage, when they can be treated successfully.

Aged↗

PubMed2003

[Corneal topography and LASIK].

PURPOSE: The purpose of this study is to outline the importance of corneal topography after LASIK surgery and to show the association between topographic findings and postoperative results. PATIENTS: One hundred and fourteen eyes, 70 patients with myopia (from -6.00 to -14.00 Dsph) who underwent surgery by LASIK. METHODS: We identified 5 types of topographic patterns which were classified to symmetric and asymmetric groups. We evaluated the association between the type of topography pattern and the following parameters: age, sex, astigmatism, pre-operative refraction, post-operative uncorrected and best corrected visual acuity. RESULTS: Fifty eight eye filled the criteria of the first group (uniform pattern), 30 eyes of the second group (bowtie), 4 eyes of the third group (penninsula), 3 eyes of the fourth group (semicircular) and 3 eyes of the fifth group (irregular pattern). Significant association between topographic corneal patterns and observed parameters has been confirmed in post-operative uncorrected visual acuity, post-operative refraction and astigmatism (p < 0.05). Age and sex were not significant parameters for the outcome of surgery. CONCLUSION: Majority of eyes (89%) had symmetric corneal topography pattern which highly surpassed our expectations. Comparison of topography patterns with observed parameters proves that the shape of ablation zone influences post-operative quality of vision.

Adolescent↗

PubMed2002

[Effect of drug therapy on lower urinary tract symptoms indicating the presence of benign prostatic hyperplasia in transurethral resection of the prostate].

OBJECTIVE: Medical therapy of lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) has fundamentally changed. The aim of the study is to verify the suggestion that the medical therapy delayed the need of operative treatment and led to changes in characteristics of patients in need of surgery, or whether it had possibly caused deterioration of the results of surgery. MATERIAL AND METHODS: A group of 137 patients treated by TURP in 1991 (before medical therapy was introduced in Slovakia) was compared with a group of 122 patients treated by TURP in 2001 when medical therapy was offered as the primary initial therapy. We evaluated the patient's age, co-morbidity, type and length of medical therapy of LUTS, indications for operation, the weight of the resected tissue, the length of urinary bladder drainage after the operation and the period of hospitalisation. RESULTS: Patients in 2001 were on average 3.1 years older (p = 0.007), co-morbidity was present in 68.6% patients in 1991 compared to 85.2% in 2001 (not significant), and TURP for objective indications was done in 58.4% of patients in 1991 and in 50% in 2001. In 2001 71 out of 122 (58.2%) patients received medical therapy and 30 of them (24.6%) were operated on for objective indications. The weight of the resected tissue was 20.2 +/- 13.2 grams in 1991 and 24.6 +/- 15.4 grams in 2001 (p = 0.027). In 1991 the catheter was removed 4.5 +/- 1.8 days after the operation compared to 3.1 +/- 2.2 days in 2001 (p = 0.0001). The duration hospitalisation in 1991 was 7.7 +/- 5.7 days compared to 5.2 +/- 3.2 in 2001 (p = 0.0001). CONCLUSIONS: Patients receiving medical therapy have surgery at a higher age. The higher age of patients was not related to co-morbidity or the increased number of operations for objective indications, nor did the complications during surgery increase. On average more of the prostatic tissue was removed and the period of hospitalisation was shorter.

Aged↗

PubMed2001

Delayed orchiectomy after chemotherapy in patients with advanced testicular cancer.

INTRODUCTION: The therapeutic procedures in the management of testicular cancer are determined by histological findings in the removed testis and by the extent of the disease at the time of diagnosis. However, all advanced tumors could be treated by primary chemotherapy regardless of the histological findings. The current imaging techniques (ultrasound of the testis, abdominal and chest CT examination) and laboratory tests (determination of serum tumor markers AFP and hCG) provide sufficient evidence for the presence of cancer. When the diagnosis of advanced tumor is evident, it is possible to start the treatment without orchiectomy. The aim of this study was to evaluate the advantages of neo-adjuvant chemotherapy with delayed orchiectomy in the management of advanced testicular cancer. MATERIAL AND METHODS: A total of 36 patients with advanced germ cell testicular cancer underwent primary PVB or BEP chemotherapy without previous orchiectomy. Mean age of patients was 32 years. Detailed medical, surgical and urological examination showed pulmonary metastases and/or extensive abdominal tumorous masses imitating acute abdominal crisis and impaired drainage of the kidney due to ureteral obstruction. Searching for the origin, testicular tumor was detected. Eleven patients had a bulky disease in the retroperitoneum (Stage IIC), two had enlarged retroperitoneal lymph nodes (Stage IIB), two had enlarged mediastinal lymph nodes (Stage III) and other 16 patients had also pulmonary metastases, and 5 pts had pulmonary metastases only. The patients were treated with cisplatin-containing combination chemotherapy. Following completion of chemotherapy, orchiectomy was performed alone or simultaneously with retroperitoneal lymph node dissection (RPLND) and/or lung metastasectomy in cases with persistent residual mass. Following orchiectomy the patients were regularly checked and in cases with viable malignant tumor found in the testis sequential chemotherapy was administered. Similarly when the relapse of the disease was detected, the patients were treated with sequential chemotherapy. RESULTS: Complete disappearance of metastases was observed in 12 patients following chemotherapy alone. The residual mass persisted in 24 patients (in 22 out of them in the retroperitoneum and in two patients also in the lungs) and was removed surgically. The viable tumor in the removed tissue was found in one patient. Delayed orchiectomy was performed simultaneously with surgical removal of residual mass in the retroperitoneum in 24 patients and as a separate procedure in 12 patients who have been considered to be complete responders following chemotherapy alone. Residual viable tumor in testicular specimen was found in three patients, necrotic or fibrotic tissue in 18, and mature teratoma in 15 patients. Overall survival of the patients was 26/36 (72.7%) at mean of 56.9 months (range 7-145 months, median 50 months) since the start of the treatment. CONCLUSIONS: In patients with advanced germ cell testicular cancer preference must be given to the early beginning of intensive chemotherapy without the need of tissue diagnosis of primary tumor that should be obtained by orchiectomy. Benefit of this therapeutic approach is the timely management of acute abdominal and/or pulmonary symptoms of life-threatening distant metastases.

Adult↗

PubMed2001

Bilateral testicular germ-cell tumors--a single centre long-term experience.

OBJECTIVES: The incidence of bilateral testicular tumors (BTT) had increased over the preceding decade. The aim of the present study is to analyse a group of patients with BTT and to high-light the need for long-term follow-up of patients treated in a single centre. MATERIAL AND METHODS: 27 (2.8%) out of 960 patients with germ-cell testicular tumors (GCTT), treated between 4/1977 and 8/2001, developed bilateral disease. All of them underwent radical orchiectomy (in one patient was done delayed orchiectomy after primary chemotherapy due to advanced disease). Additional treatment was planned according to the histologic type and clinical stage of the disease, and previous treatment as well. The survival data were reviewed. RESULTS: 24 out of 27 patients (88.9%) developed the 2nd tumor metachronously (median interval 66 months, range, 4-197 months) and three (11.1%) had synchronous BTT. Only 7 patients (25.9%) had identical histological types on both sides (6 of them with pure seminomas, one with embryonal carcinoma). Two of three synchronously developed BTT had different histologic types on both sides. GCTT of one histologic type were observed in respect of the first tumor: 11 seminomas, three embryonal carcinomas, in respect of the 2nd tumor: 10 seminomas, three embryonal carcinomas, in respect of the 2nd tumor: 10 seminomas, three embryonal carcinomas and one mature teratoma. GCTT of more than one histologic type were observed in respect of the first and the 2nd tumors: 6 mixed GCTT with seminoma component and 7 without seminoma component. Majority of BTT was presented in clinical stage I (in respect of the first tumor in 70.4%, in respect of the 2nd tumor in 62.9%). The median duration of the follow-up after the diagnosis of the first GCTT was 149 months (range, 13-288 months) and after the diagnosis of the contralateral GCTT was 68 months (range, 1-167 months). Twenty-five patients (92.6%) were alive with NED at their last follow-up visit. Two patients died by mean of 22.5 months (range, 21-24 months) after the 2nd orchiectomy. CONCLUSIONS: All patients with unilateral GCTT have an increased risk of developing a contralateral testicular tumor, even decades after diagnosis. Management should be individualised for each patient.

Adolescent↗

PubMed2001

[Delayed orchiectomy and surgery of metastases after primary chemotherapy in the treatment of advanced testicular tumors].

OBJECTIVE: The therapeutic procedures in the management of testicular germ cell tumors (TGCT) are determined by histological findings in the removed testis and by the extent of the disease at the time of diagnosis. However, all advanced TGCT could be treated by primary chemotherapy (CHT) regardless of histological findings. The current imaging techniques (ultrasonography of the testis, abdominal and thoracic CT examination) and laboratory tests (determination of serum tumor markers AFP and hCG) provide sufficient evidence for the presence of TGCT. In cases of acute abdominal and/or pulmonary symptoms because of life-threatening distant metastases, when the diagnosis of advanced TGCT is evident, it is possible to start the treatment without primary orchiectomy (OE). The aim of this study was to evaluate the advantages of neo-adjuvant CHT with delayed OE in the management of advanced TGCT. MATERIAL AND METHODS: During last 12 years a total of 40 patients with advanced TGCT were treated by neo-adjuvant cisplatin-based combination CHT without previous OE. Eleven patients had bulky mass in the retroperitoneum (Stage IIC), three patients had enlarged retroperitoneal lymph nodes (Stage IIB), two patients had enlarged mediastinal lymph nodes (Stage III). Another 24 patients had pulmonary metastases (Stage IV), 15 of them had also bulky mass in the retroperitoneum and 6 of them in the mediastinum. Following the completion of CHT, OE was performed alone or simultaneously with retroperitoneal lymph node dissection (RPLND) and subsequent lung metastasectomy in cases with persistent residual mass. RESULTS: Complete disappearance of metastases was observed in 13 (32.5%) patients following PVB or BEP CHT alone. The residual mass in the retroperitoneum was removed surgically in 27 patients. In three of them residual tumorous mass was removed also from the lungs without finding of viable tumor. Viable malignant tumor in the removed retroperitoneal tissue was identified in two patients (7.4%). Residual viable malignant tumor in the testis was found in 5 patients (12.5%). Overall survival was 29/40 patients--72.5% (by mean of 55.2 months since the start of the therapy). CONCLUSIONS: The benefit of this therapeutic approach in the immediate management of acute abdominal and/or pulmonary symptoms of life-threatening distant metastases. Another advantage is the like hood of surgical treatment of residual metastatic masses simultaneously with delayed OE on the same day, under one anaesthesia.

Adult↗

PubMed1998

Prognostic factors in clinical stage I nonseminomatous germ cell testicular tumors: rationale for different risk-adapted treatment.

OBJECTIVE: Surveillance after orchiectomy alone becomes popular for the management of clinical stage I nonseminomatous germ cell testicular tumours (CS I NSGCTT). Effort to identify patients at high risk of relapse leads to searching prognostic factors of CS I NSGCTT. The aim of this study was to identify those patients in whom a surveillance policy is less likely to be successful. PATIENTS AND RESULTS: Seventy-two CS I NSGCTT patients were stratified to different risk-adapted therapeutic approaches according to histopathologic findings of primary tumor removed by inguinal orchiectomy. Eighteen patients (group A) with vascular invasion and majority of embryonal carcinoma component in the primary tumor were treated with adjuvant BEP chemotherapy. None of them experienced disease progression after a median follow-up period of 36 months after orchiectomy. Five patients (group B) with vascular invasion and the majority of teratomatous elements in the primary tumor have been followed up 56 months after orchiectomy. They were treated with primary retroperitoneal lymph node dissection (RPLND). Two of them (40%) had pathologic stage II after RPLND and underwent subsequent chemotherapy. One of them died due to disease progression 29 months following orchiectomy. Another one lives with no evidence of disease (NED). Three patients in pathologic stage I are alive with NED. Forth-nine patients (group C) without vascular invasion have been followed up for a median duration of 37 months after orchiectomy. They were kept under close surveillance, consisted of regular follow-up with tumor markers, chest x-ray and CT of the retroperitoneum. Disease progression was observed in 7 (14.3%) patients after a median duration of 8 months after orchiectomy. They were treated with BEP chemotherapy and live with disease-free median survival of 22 months after completion of therapy. The overall survival rate of all 72 patients was 98.6%. The median survival for all patients was 37 months (range 7-73). CONCLUSIONS: The authors will continue to use surveillance policy only in patients without vascular invasion in the primary tumor.

Adolescent↗

PubMed1998

[Incidental renal carcinoma].

BACKGROUND: The increasing use of progressive noninvasive diagnostic imaging techniques, has substantially increased the detection of incidentally detected renal cell carcinoma (RCC). OBJECTIVES: To determine the manner of presentation of RCC and the frequency of incidentally detected RCC. The natural history of RCC of incidentally discovered RCC was compared with that of symptomatic RCC, the reasons for examination and the methods of diagnosis in patients with incidental tumours were analysed. PATIENTS AND METHODS: In a retrospective study, 463 patients with RCC treated between 1981 and 1995 were reviewed. The patients were divided into four groups according to the fact as to whether the tumours were diagnosed on the basis of urologic symptoms, with paraneoplastic syndromes, with symptoms of metastatic disease, or whether they were detected incidentally. The records of 180 patients with RCC treated between 1991 and 1995 were grouped according to the fact as to whether the tumour was detected incidentally (n = 85), or whether it was discovered with symptoms related to the neoplastic renal disease (n = 95). The groups were compared regarding patient's age, sex, tumour size, grade of malignancy, stage and survival using univariate analyses. RESULTS: The number of RCC detected incidentally has increased from 9.3% (1981-1985) to 47.2% (1991-1995). There were significant differences between groups in the distribution of clinical stages, T1 + T2 stages were more frequently detected in incidental tumours (p < or = 0.005). No significant difference was observed between the survival of incidental and symptomatic patients. Abdominal ultrasonography was the most useful method for the detection of incidental RCC (88.2%). CONCLUSIONS: The results of this study suggest that the incidentally detected RCC occur in lower stages than the symptomatic tumours.

Carcinoma, Renal Cell↗

PubMed1997

[Will determination of prostate specific antigen density improve the diagnosis of prostatic carcinoma?].

Prostate specific antigen (PSA) serum levels in patients with prostate carcinoma and with benign prostate hyperplasia overlap. In order to improve the positive predictive value of PSA in the diagnosis of prostate carcinoma the authors recommend to evaluate the PSA levels in relation to the prostate volume, the so-called density of the prostate specific antigen (PSAD). The correlation of PSA and PSAD with results of bioptic examination revealed that PSAD does not increase the capacity of PSA to predict the presence of prostate carcinoma and does not reduce the number of prostate biopsies. All patients with PSA levels higher than 4 ng/ml and/or a pathological finding on digital rectal examination need a bioptic examination of the prostate.

Aged↗

PubMed1997

[The antiandrogen withdrawal syndrome: decrease in prostate specific antigen serum levels after withdrawal of antiandrogens].

Combined androgen blockade using surgical or medical (luteinizing hormone-releasing hormone agonist) castration in association with anti-androgen has become the primary therapy in patients with metastatic prostate cancer. Patients undergoing combined androgen blockade will progress within 18-30 months after initial hormonal therapy. When progression occurs following combined androgen blockade, the non-steroid anti-androgen should be subsequently withdrawn. Several recent reports have been published on the paradoxical effect of anti-androgen withdrawal. Eight (22.9%) of 35 patients showed a decline in PSA levels following flutamide withdrawal. The mean time to progression following combined androgen blockade was 26 month and the mean duration of response to flutamide withdrawal was 4.1 months.

Aged↗

PubMed1996

[Diagnosis of renal tumors with percutaneous biopsy].

The authors describe four, out of 506 cases of renal biopsies in which this diagnostic procedure enabled to reveal a tumour. Two cases of tumours which were intentionally subdued to renal biopsy justified an angiomyolipoma and a focus (metastasis) of tubulopapillomatous carcinoma) in the kidney. In one case the renal biopsy revealed renal infiltration thus enabling to state the diagnosis of chronic lymphatic leukaemia subsequently, and in the last case where the diagnosis of chronic lymphatic leukaemia had been stated in advance, the renal biopsy was performed due to suspective glomerulonephritis. In these cases the unexpected results of renal biopsy were of great diagnostic value. Such intentional use of biopsy is rare. (Fig. 3, Ref. 6.)

Adult↗

PubMed1996

Postchemotherapy surgery in nonseminomatous testicular tumors.

Two hundred and twenty patients with metastatic nonseminomatous germ cell testicular tumors received primary chemotherapy including cisplatin, vinblastine and bleomycin (PVB). Complete response was achieved with chemotherapy alone in 108 (49.1%) patients. Postchemotherapy surgery of the residual mass was done in 85 (38.6%) patients with normalized serum tumor markers. Laparotomy was done in 62 patients, 19 patients underwent thoracic surgery, and 4 patients had both postchemotherapy treatments. Thirteen (5.9%) patients had persistently elevated serum tumor markers, they died despite salvage second-line chemotherapy. Fourteen (6.4%) patients died during primary PVB chemotherapy. The masses removed at laparotomy consisted of necrotic and/or fibrotic tissue in 25.8%, mature teratoma in 61.3% and viable cancer was detected in 12.9% of cases. In contrast, resected pulmonary masses consisted of necrotic and/or fibrotic tissue in 42.1%, mature teratoma in 26.3% and viable cancer in 31.6%. The total therapeutic outcome in 220 patients was as follows: 159 (72.3%) patients are alive and free of disease; 4 (1.8%) patients live with disease, and 57 (25.9%) died of the disease.

Adolescent↗

PubMed1996

Management of germ cell testicular cancer with pulmonary metastases.

Twenty eight patients with germ cell testicular cancer pulmonary metastases received primary chemotherapy including bleomycin, etoposide, and cisplatin (BEP). Complete response was achieved in 21 (75%) patients, in 11 of them CR was achieved following chemotherapy alone. Postchemotherapy surgery of residual mass was performed in 12 (42.9%) patients with normalized serum tumor markers. Retroperitoneal lymph node dissection was performed in one patient, pulmonary surgery in four, and both postchemotherapy treatments in 7 patients. Overall cure rate was 89.3%, 26 (92.9%) patients are still alive at a mean follow-up of 19.7+ months (range, 3-34+ months) after the treatment start. Two (7.1%) patients died: one of them due to disease progression during chemotherapy, and the second one due to postoperative complication (acute respiratory failure). Relapse of disease was observed in one patient 21 months following CR achievement, and sequential chemotherapy was introduced. Authors recommend surgical remove of all radiologically detected residual deposits, because the available imaging methods are not adequate for determining the histologic composition of residual mass, which is decisive for further therapy and has prognostic value.

Adolescent↗

PubMed1995

Transformation of the Bricker to a continent urinary reservoir to eliminate severe complications of uretero-ileostomy performed in eight patients among 200 Bricker.

Between 1969 and 1994 urinary diversion via the ileal loop (Bricker's operation) was performed in 200 patients. After introduction of methods of continent urinary diversion into clinical practice, some of young patients operated in childhood for congenital lower urinary tract malformations demanded the conversion of the primary diversion. The decision was influenced, however, not only by subjective complaints but also by severe complications having relation to the long-lasting presence of stoma. A modified Mainz pouch I, with a catheterizable stoma was constructed in 6 patients with primary uretero-ileostomy made 7 to 22 years prior to conversion because of exstrophy of the urinary bladder or a neurogenic bladder with total urine incontinence. The ileal loop used for uretero-ileostomy was detubularized or combined with additional segments of ileum and colon. The ileal stoma was connected to the umbilicus. In other two patients suffering from a neurogenic bladder the uretero-ileostomy was converted to an orthotopic ileal pouch. The authors present long-term results (1.5 to 7 years) of follow-up with urodynamic and radiological evaluation. The results both compensate the urologist's efforts and enhance the patient's quality of life.

Adolescent↗

PubMed1994

Chronic ischaemia of the ileal neobladder: clinical manifestations and management.

Recently, bladder replacement with intestinal reservoir is becoming more common as urinary diversion in a selected group of patients after radical cystectomy. Complications occurred in two patients, 2 and 7 months, respectively, after successful radical cystoprostatectomy and reconstruction of the ileal neobladder, due to chronic ischaemic changes of the latter. Their clinical manifestations and management are discussed. Some of the possible potential mechanisms responsible for ischaemic changes of the reservoir are reviewed.

Adult↗

PubMed1994

Advantages of converting incontinent to continent urinary diversion.

A modified Mainz pouch with catheterizable stoma was constructed in six patients who had originally undergone incontinent urinary diversion by ureteroileostomy 7 to 22 years previously for bladder exstrophy or neurogenic bladder with total urinary incontinence. The surgical technique differed from the standard as follows: after stomal excision, the preexisting ileal loop was detubularized and combined with additional ileal and colonic segments for pouch construction. In patients in whom the original ureteroileal anastomoses were patent and the contrast medium refluxed freely to the upper urinary tract during loopography, the ureters were not reimplanted but kept intact. In all patients the ileal valve was connected as stroma to the umbilicus. In addition, two patients underwent construction of a standard Mainz pouch. One had had primary ureterosigmoidostomy and the other one ureterostomies, 10 and 3 months previously, respectively. The urodynamic characteristics of the reservoir were normal in all. In six ureteropelvic units dilation improved significantly and in two patients the bilateral loop-ureter reflux diminished. Long-term follow-up (up to 45 months) showed no further impairment of the kidneys.

Adolescent↗

PubMed1994

[Surgical activities at urologic departments in Slovakia 1990-1993].

In 1990 "The classification of urological operations" was introduced to all urological departments in Slovakia. The aim of the classification was to evaluate the quality of work of individual departments in respect of recent trends in surgical therapy. The annual analysis shows the procedures, which are necessary to be replaced by modern ones. The review of the first four-years shows the increase in number of operations almost by one third. Twenty of most common operations represent 73.4% of all urological procedures. The most frequent operation is prostatectomy accounting 11.8% of all operations. During the follow-up period the therapy of urolithiasis has changed principally. The results of surgical activity analysis support the need to extend methods of urinary diversion using intestine and to increase the number of radical cystectomies and prostatectomies.

Female Urogenital Diseases↗

PubMed1994

Systemic chemotherapy for muscle invasive bladder cancer.

A total of 60 patients with muscle invasive transitional cell carcinoma of the bladder were entered into the nonrandomized study. The 1st group consisted of 30 patients treated by M-VAC neo-adjuvant chemotherapy followed by radical cystectomy when a residual tumor had been detected by biopsy made after the treatment. The overall clinical response was 70%. Fifteen (50%) out of 30 patients achieved clinical complete response (cCR). Objective pathologic response was attained in 6 (66.7%) of 9 evaluable patients who underwent radical cystectomy, pathologic complete response (pCR) was observed in two (22.2%) patients. Ten (33.3%) patients are still alive at a median follow-up of 22+ months. There were three (10%) drug-related deaths. The 2nd group consisted of 30 patients treated by CMV (with carboplatin) neo-adjuvant chemotherapy followed by radical pathologic response was attained in 9 (47.4%) of 19 evaluable patients, with pCR in 6 (31.6%) patients. Twenty four (80%) patients are still alive at a median follow-up of 13+ months. There was one (3.3%) drug-related death. The authors recommend immediate radical cystectomy following neo-adjuvant chemotherapy in all patients if their total status it allows.

Adult↗