Clinical and pathological predictors of early recurrence after neoadjuvant cisplatin gemcitabine in muscle invasive bladder cancer in the RealBLADDER study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Neoadjuvant cisplatin-based chemotherapy (NAC) confers a survival benefit in muscle-invasive bladder cancer (MIBC), however a relevant proportion of patients experience early disease recurrence following radical cystectomy. We conducted a multicenter observational study to evaluate clinical, pathological, and laboratory factors associated with early recurrence defined as disease-free survival [DFS] ≤ 12 months in patients with MIBC treated with neoadjuvant cisplatin plus gemcitabine followed by radical cystectomy. Early recurrence was significantly associated with aggressive pathological features, including higher ypT stage, nodal involvement, lymphovascular invasion, and lower rates of pathological complete response. Patients experiencing early recurrence predominantly presented with systemic dissemination and had significantly shorter DFS and overall survival (OS). Variant histology and the presence of post-treatment lymphovascular invasion were independently associated with early recurrence. Early recurrence after NAC identifies a subgroup of patients with aggressive clinicopathological features and poorer oncological outcomes, highlighting the need for improved postoperative risk stratification and novel perioperative treatment strategies.
Source: Scientific Reports
Authors: Giandomenico Roviello, Elisabetta Gambale, Roberta Giorgione, Umberto Basso, Maria Oliveri, Malvina Cremante, Francesco Atzori, Sarah Scagliarini, Cristina Masini, Valentina Baldazzi, Federico Scolari, Marinella Micol Mela, Eleonora Lai, Ismaela Anna Vascotto, Virginia Rossi, Chiara Calandrelli, Daniele Rossini, Daniele Lavacchi, Sergio Serni, Andrea Minervini, Serena Pillozzi, Lorenzo Antonuzzo
Institutions: University of Florence, Azienda Ospedaliero-Universitaria Careggi, Istituto Oncologico Veneto, Azienda Ospedaliera Universitaria Pisana, Ospedale Policlinico San Martino, Ospedaliero Sirai, Ospedale Antonio Cardarelli, Azienda Sanitaria Unità Locale di Reggio Emilia, Ospedale Santa Maria Annunziata
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,690
Funder: AstraZeneca
OpenAlex ID: W7165109448
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