Pd33-07 Partial Vs. Complete Response to Neoadjuvant Chemotherapy in Muscle-invasive Bladder Cancer Patients: a Comparison of Post-cystectomy Outcomes
Year: 2016
Type: article
Study design: Observational Study
Abstract: You have accessJournal of UrologyBladder Cancer: Invasive IV1 Apr 2016PD33-07 PARTIAL VS. COMPLETE RESPONSE TO NEOADJUVANT CHEMOTHERAPY IN MUSCLE-INVASIVE BLADDER CANCER PATIENTS: A COMPARISON OF POST-CYSTECTOMY OUTCOMES Aaron Brant, Max Kates, Meera Chappidi, Hiten Patel, Nikolai Sopko, and Trinity Bivalacqua Aaron BrantAaron Brant More articles by this author , Max KatesMax Kates More articles by this author , Meera ChappidiMeera Chappidi More articles by this author , Hiten PatelHiten Patel More articles by this author , Nikolai SopkoNikolai Sopko More articles by this author , and Trinity BivalacquaTrinity Bivalacqua More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.716AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Several randomized controlled trials have found that neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC) provides a survival benefit to patients who achieve complete pathologic response. We compared survival and recurrence outcomes between partial and complete responders. METHODS We identified 225 consecutive patients with ≥cT2 urothelial carcinoma who received neoadjuvant chemotherapy prior to RC at our institution from 2005-2014. Partial response was defined as down-staging to pT1, pTis, or pTa at RC, and complete response was defined as down-staging to pT0. Characteristics between partial and complete responders were compared using Wilcoxon-Mann-Whitney for continuous and chi-squared for categorical variables. Cox regression was used to identify predictors of recurrence and survival in both partial and complete responders, adjusting for age, BMI, gender, race, smoking status, Charlson score, intravesical therapy, clinical stage, and degree of pathologic response. RESULTS In our cohort of 225 patients, 69 (30.7%) achieved partial response and 51 (22.7%) achieved complete response. The only significant difference between partial and complete responders was median days from NAC initiation to RC (160 vs. 140, p=.03). Cox regression found that partial and complete response were each independent predictors of decreased cancer recurrence (hazard ratio (HR)=.194 and .128, p<0.01) and overall mortality (HR=.140 and .129, p<0.01). Log-rank test found no difference in recurrence-free survival or overall survival between partial and complete responders. CONCLUSIONS The benefit of NAC is not limited to patients who achieve complete pathologic response. Complete and partial responders were each associated with improved recurrence-free survival and overall survival when compared to non-responders. There was no significant difference in recurrence-free survival or overall survival between partial and complete responders. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e768 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Aaron Brant More articles by this author Max Kates More articles by this author Meera Chappidi More articles by this author Hiten Patel More articles by this author Nikolai Sopko More articles by this author Trinity Bivalacqua More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2313311380