Kết quả điều trị bước một ung thư biểu mô đường niệu tái phát/di căn bằng phác đồ gemcitabin – cisplatin tại Bệnh viện K

Urothelial carcinoma, particularly in its recurrent or metastatic forms, represents a significant clinical challenge with a poor prognosis. Effective first-line treatment is crucial for improving patient outcomes. The Gemcitabine-Cisplatin regimen has long been a cornerstone therapy for this aggressive cancer, yet its real-world efficacy and safety profile, especially within specific regional healthcare settings like K Hospital in Vietnam, often require dedicated evaluation. Understanding the characteristics of treated patients and the specific outcomes associated with this regimen is vital for optimizing clinical management and guiding future therapeutic strategies. This study aims to describe the clinical and subclinical features, and the treatment outcomes of first-line Gemcitabine-Cisplatin in patients with recurrent or metastatic urothelial carcinoma.

Oncologists, urologists, internal medicine specialists, medical researchers, and healthcare professionals involved in the diagnosis and treatment of urothelial carcinoma.

This descriptive study investigated the clinical and subclinical characteristics, and the outcomes of first-line treatment with the Gemcitabine-Cisplatin regimen in 33 patients with recurrent or metastatic urothelial carcinoma at K Hospital, spanning from January 2018 to June 2025. Patients had a mean age of 63.15 years, with a predominant male representation (93.9%) and bladder as the primary tumor site (78.8%). The study revealed a notable treatment response rate of 62.5% after six cycles of Gemcitabine-Cisplatin. However, the median progression-free survival (PFS) was limited to 8.0 months (95% CI: 6.6-9.4), emphasizing the aggressive nature of the disease despite initial response. A significant correlation was observed between performance status and PFS (p = 0.036). Regarding safety, hematologic toxicity was the most common adverse event, particularly neutropenia, with grade 3-4 hematologic events occurring in 17% of patients. While the Gemcitabine-Cisplatin regimen demonstrates a high response rate and acceptable toxicity, suggesting its continued utility as a first-line option, the restricted median progression-free survival highlights the need for further strategies to improve long-term outcomes, such as integrating maintenance therapies or novel agents. The findings provide valuable local data for optimizing treatment protocols for urothelial carcinoma recurrence/metastasis.