Survival benefit for patients with metastatic urothelial carcinoma receiving continuous maintenance chemotherapy

Chuang Chi Liaw, Tzu Yao Liao, Ke Hung Tsui, Yu Hsiang Juan

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Background/Aim: Urothelial carcinoma is a chemo-sensitive cancer. We investigated the contributory factors to survival benefit of metastatic urothelial carcinoma (MUC) patients receiving continuous maintenance chemotherapy. Patients and Methods: Inclusion criteria were: i) pathology-confirmed urothelial carcinoma, ii) metastatic lesions identified mainly on pre-therapy computed tomography (CT) scans, and iii) inpatient-administered chemotherapy of at least three cycles. Chemotherapy regimens included 5-fluorouracil, leucovorin, cisplatin, and gemcitabine. Results: A total of 139 cases were enrolled in this study. The overall objective response rate was 60% and the median survival time was 17 months. Eight-two (59%) patients had inflammation-related symptoms following the course of chemotherapy. Fifty-five (41%) patients survived more than two years. All patients exhibited various fibrosis formations. No patient experienced unfavorable metastatic conditions. Inflammation-related symptoms remained in 28 (51%) patients. We found that surgery, invasive procedures, and infection likely led to a rapid tumor progression. Conclusion: Continuous maintenance chemotherapy targeting chemo-sensitive tumors, administered at metronomic intervals and focus on tumor microenvironment, can increase MUC survival benefits.

Original languageEnglish
Pages (from-to)1249-1262
Number of pages14
JournalIn Vivo
Issue number4
Publication statusPublished - 2019
Externally publishedYes


  • Chemotherapy
  • Computed tomography
  • Maintenance chemotherapy inflammation
  • Metastases
  • Urothelial carcinoma

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Pharmacology

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