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OBJECTIVE To report the epidemiolgical, anatomo-clinical features, treatment and therapeutic results in metastatic bladder cancer in Tunisian patients. PATIENTS AND METHODS Our retrospective study concerned patients presenting a metastatic (synchronous or metachronous) bladder cancer treated in our department. We collected the data concerning epidemiological, anatomo-clinical features, treatment and therapeutic results. RESULTS We collected 21 patients from 2011 to 2018, having a mean age of 64 years (42 to 85) and a 9 sex-ratio. They have 72% of metachronous and 28% of synchronous metastases with a mean time of 10 months after surgery. Surgery was performed 14/21(66%) were operated and only 28% (4/14) received adjuvant chemotherapy performed with mean time of 56 days.4 patients recei ved a neoadjuvant treatment followed by radiotherapy in 3 cases. Metastatic sites were bones and lungs in 51% and 48%, liver in 24% of cases. 44% of patients required opioids for pain in. 1st line chemotherapy consisted for 89% of patients, mostly with gemcitabin-cisplatin (27%), gemcitabin-carboplatin (27%), of monotherapy in 13% of cases. Treatment was complicated by renal in 10% and hematologic toxicity in 24% of cases. We observed 34% objectives response-stable disease. 17% of patients received a 2nd line chemotherapy with monotherapy, in a mean number of cycles of 3 and 62% of them progressed under therapy. 37% received a 3rd line treatment. With a median follow-up of21 months, median survival was 8months for synchronous metastases and 15 months after initial diagnosis. Univariate analysis showed significance of hemoglobin cut-off at 10g/l (13 versus 7 months, p=0.008) and liver metastases(13 versus 7 months, p=0.04). CONCLUSION Metastatic bladder cancer is a poor-prognosis disease requiring a heavy treatment, frequentlyburdened by the initial patient's general status. [ABSTRACT FROM AUTHOR]

OBJECTIVE To report the epidemiolgical, anatomo-clinical features, treatment and therapeutic results in localized bladder cancer in Tunisian patients. PATIENTS AND METHODS Our retrospective study concerned patients presenting a localized bladder cancer treated in our department. We collected the data concerning epidemiological, anatomo-clinical features, treatment and therapeutic results. RESULTS We collected 37 patients from 2011 to 2018, having a mean age of 64 years (42 to 85) and 9 sex-ratio. Tumor were at stages pT2 in 45% of cases and pT1 in 13.5% and missed for the other patients. On histology, tumors were of high grade in 59% of cases and N+ in imagery with presence of an urothelial carcinomain 70% of endoscopic samples.8/37 patients received a neoadjuvant chemotherapy mostly with carboplatin and gemcitabin and a mean number of cycles of 3. On the 7 evaluated patients, we observed 4 objectives responses and 3 stable disease. 4 patients received adjuvant radiotherapy. Primary surgery concerned 22pts (59,5%), 6 (16,2%) received adjuvant radiotherapy and 4(10.8%). Adjuvant chemotherapy was administered to 13 patients (35%). Protocols consisted in MVAC-HDin 1 patient, Gemzar-CDDP in 10.8% and gemcitabine-carboplatinin 18.9% of cases with a mean number of 4 cycles. With a median follow-up of 22months, median survival was 12 months CONCLUSION The treatment of bladder cancer requires a mutlidisciplinary management with urologists, medical oncologists, radiotherapists and radiologists. However most of our patients have a delayed diagnosis and locally advanced tumours. [ABSTRACT FROM AUTHOR]