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PD15-09 NEOADJUVANT VS ADJUVANT CHEMOTHERAPY FOR MUSCLE-INVASIVE BLADDER CANCER: A PROPENSITY MATCHED ANALYSIS

2018; Lippincott Williams & Wilkins; Volume: 199; Issue: 4S Linguagem: Inglês

10.1016/j.juro.2018.02.808

1527-3792

Joshua S. Jue, Tulay Koru‐Sengul, Feng Miao, Maria C. Velasquez, Luís Felipe Sávio, Mahmoud Alameddine, Zachary Kroeger, Chad R. Ritch, Mark L. Gonzalgo,

Urinary and Genital Oncology Studies

You have accessJournal of UrologyBladder Cancer: Invasive II1 Apr 2018PD15-09 NEOADJUVANT VS ADJUVANT CHEMOTHERAPY FOR MUSCLE-INVASIVE BLADDER CANCER: A PROPENSITY MATCHED ANALYSIS Joshua Jue, Tulay Koru-Sengul, Feng Miao, María Velásquez, Luís Sávio, Mahmoud Alameddine, Zachary Kroeger, Chad Ritch, and Mark Gonzalgo Joshua JueJoshua Jue More articles by this author , Tulay Koru-SengulTulay Koru-Sengul More articles by this author , Feng MiaoFeng Miao More articles by this author , María VelásquezMaría Velásquez More articles by this author , Luís SávioLuís Sávio More articles by this author , Mahmoud AlameddineMahmoud Alameddine More articles by this author , Zachary KroegerZachary Kroeger More articles by this author , Chad RitchChad Ritch More articles by this author , and Mark GonzalgoMark Gonzalgo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.808AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Neoadjuvant (NAC) or adjuvant (AC) chemotherapy have become increasingly utilized for management of muscle-invasive bladder cancer (MIBC) in combination with radical cystectomy (RC). We directly compared survival outcomes among patients who received either NAC or AC and RC. METHODS We identified patients in the National Cancer Data Base (NCDB) diagnosed with clinical T2-T4, N0, M0 urothelial cell carcinoma who underwent RC. Patients who received NAC were propensity matched by age, race, ethnicity, sex, insurance type, academic/research program, comorbidity, and clinical stage to patients receiving AC within 90 days of RC. Median survival was calculated using Kaplan-Meier analysis. Adjusted hazard ratios (aHR) and 95% confidence intervals (95% CI) were calculated from multivariable Cox regression models to compare overall survival (OS), downstaging to non-MIBC (NMIBC), and N upstaging. RESULTS A total of 509 patients treated with NAC and 283 patients treated with AC were identified from 2004-2013. Patients who received NAC had better 5 year OS (50.3%, 95% CI: 43.2%-57.0%) compared to patients who received AC (38.0%, 95% CI: 32.0%-44.0%). NAC was a significant predictor of decreased mortality, decreased progression to node positivity, and downstaging to NMIBC (0.68, 0.54-0.86, p=0.001; 0.18, 0.12-0.26, p<0.001; 12.75, 6.06-26.81, p<0.001). Increasing clinical T stage was a significant predictor of decreasing probability of pathologic node positivity in patients who received AC. CONCLUSIONS The use of NAC+RC was associated with better OS compared to RC+AC for patients diagnosed with T2-T4, N0, M0 bladder cancer. The increased survival benefit associated with NAC compared to AC among patients undergoing RC may be due to decreased progression to node positivity and pathologic downstaging. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e313 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Joshua Jue More articles by this author Tulay Koru-Sengul More articles by this author Feng Miao More articles by this author María Velásquez More articles by this author Luís Sávio More articles by this author Mahmoud Alameddine More articles by this author Zachary Kroeger More articles by this author Chad Ritch More articles by this author Mark Gonzalgo More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...