Indian Journal of Cancer
Home  ICS  Feedback Subscribe Top cited articles Login 
Users Online :1673
Small font sizeDefault font sizeIncrease font size
Navigate here
  Search
 
  
Resource links
   Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
   Article in PDF (212 KB)
   Citation Manager
   Access Statistics
   Reader Comments
   Email Alert *
   Add to My List *
* Registration required (free)  

 
  In this article
   References

 Article Access Statistics
    Viewed600    
    Printed17    
    Emailed0    
    PDF Downloaded91    
    Comments [Add]    

Recommend this journal

 


 
  Table of Contents  
LETTER TO THE EDITOR
Year : 2014  |  Volume : 51  |  Issue : 4  |  Page : 556
 

Response to article - Mohanty NK, Kumar A, Vasudeva P, Jain M, Prakash S, Arora RP. Analysis of the perioperative and five-year oncological outcome of two hundred cases of open radical cystectomy: A single center experience. Indian J Cancer 2012;49 (1):96-101


1 Department of Radiation Oncology, Malabar Cancer Centre, Thalassery, Kerala, India
2 Department of Surgical Oncology, Malabar Cancer Centre, Thalassery, Kerala, India

Date of Web Publication1-Feb-2016

Correspondence Address:
Dr. M Kumar
Department of Radiation Oncology, Malabar Cancer Centre, Thalassery, Kerala
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-509X.175327

Rights and Permissions



How to cite this article:
Kumar M, Chakraborty S, Satheeshan B. Response to article - Mohanty NK, Kumar A, Vasudeva P, Jain M, Prakash S, Arora RP. Analysis of the perioperative and five-year oncological outcome of two hundred cases of open radical cystectomy: A single center experience. Indian J Cancer 2012;49 (1):96-101. Indian J Cancer 2014;51:556

How to cite this URL:
Kumar M, Chakraborty S, Satheeshan B. Response to article - Mohanty NK, Kumar A, Vasudeva P, Jain M, Prakash S, Arora RP. Analysis of the perioperative and five-year oncological outcome of two hundred cases of open radical cystectomy: A single center experience. Indian J Cancer 2012;49 (1):96-101. Indian J Cancer [serial online] 2014 [cited 2019 Sep 17];51:556. Available from: http://www.indianjcancer.com/text.asp?2014/51/4/556/175327


Sir,

We congratulate the authors on the publication of one of the largest prospectively recorded a series of Indian patients with carcinoma urinary bladder undergoing open radical cystectomy.[1] However, we would like to make certain observations.

The results have not been analyzed according to age of the patients as the morbidity in elderly would be interesting to know. Furthermore, if the results were stratified according to combined stage analysis it would have been more informative as compared with stratification as per the T stage only.

Interestingly, in this series of patients about 23% of the patients underwent neoadjuvant chemotherapy or radiotherapy as compared with a report by Gupta et al.[2] in which none of the cases had received neoadjuvant therapy.

Further another 14.5% had undergone intravesical treatment. Details regarding this important aspect of treatment are however missing from the manuscript as well as any potential impact these treatments may have had on the eventual outcome of patients. Another point of oversight perhaps is that while in the main text it is mentioned that patients received Gemcitabine and cisplatin as the neoadjuvant chemotherapy regimen, the table reports that as methotrexate, vinblastine, doxorubicin, cisplatin combination therapy. A clarification in this aspect as well as an analysis of cases receiving neoadjuvant therapy compared with cases treated with upfront surgery would be an extremely meaningful data relevant for our clinical practice.

Equally valuable would the comparison of the outcomes of patients treated with neoadjuvant radiotherapy as compared with neoadjuvant chemotherapy. This information could be crucial in understanding overall failure pattern as well as the analysis is presented according to pathological staging only. The analysis of the fact that whether or not neoadjuvant therapy could downstage the disease and what was the subsequent effect on the overall outcome would provide vital information. A comprehensive clinicopathological correlation would have been commendable.

The distant recurrence rate seen is 4.5% at a median follow-up of 60.1 months as compared with study by Gupta et al.[2] report of 24.3% at comparable period. This is another area where probably neoadjuvant therapy may have favored the authors.

Once again, we would like to thank the authors for providing this is a very positive and important baseline data about a group of patients of largely organ confined carcinoma urinary bladder treated with open radical cystectomy with relevance to our day-to-day practice in India.

 
  References Top

1.
Mohanty NK, Kumar A, Vasudeva P, Jain M, Prakash S, Arora RP. Analysis of the perioperative and five-year oncological outcome of two hundred cases of open radical cystectomy: A single center experience. Indian J Cancer 2012;49:96-101.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Gupta NP, Kolla SB, Seth A, Dogra PN, Hemal AK, Kumar R, et al. Radical cystectomy for bladder cancer: A single center experience. Indian J Urol 2008;24:54-9.  Back to cited text no. 2
[PUBMED]  Medknow Journal  




 

Top
Print this article  Email this article
 

    

  Site Map | What's new | Copyright and Disclaimer
  Online since 1st April '07
  2007 - Indian Journal of Cancer | Published by Wolters Kluwer - Medknow