AI Summary & Key Takeaways
AI InsightThere was no significant difference between the groups regarding patient age, sex, preoperative clinical staging, lymph node invasion, comorbidity, type of urinary diversions done, postoperative early complications, progression-free survival (21.96 ± 3.5 and 23.44 ± 2.5 months; P = 0.275), and overall survival rates (25.76 ± 3.5 and 23.57 ± 2.4 months; P = 0.646).
📌 3 Key Takeaways
Abstract
Aim: To evaluate the effect of neoadjuvant chemotherapy on tumor pathology and patient survival in patients with muscle-invasive bladder cancer undergoing radical cystectomy. Neoadjuvant chemotherapy is believed to prevent micrometastasis and provide pathological downstaging. Materials and methods: Between June 2004 and March 2009, 74 patients with muscle-invasive bladder cancer were treated with radical cystectomy. Patients fit to receive chemotherapy were administered systemic chemotherapy of methotrexate, vinblastine, Adriamycin, and cisplatin (MVAC); gemcitabine and cisplatin (GC); or carboplatin and gemcitabine (CG). Patients in Group 1 (n = 36) did not receive any chemotherapy, while the remaining 38 patients in Group 2 did so, before radical cystectomy. Patient characteristics, pathological staging, and survival analysis were compared statistically between groups. Results: The mean follow-up time was 16.12 ± 12.13 months. There was no significant difference between the groups regarding patient age, sex, preoperative clinical staging, lymph node invasion, comorbidity, type of urinary diversions done, postoperative early complications, progression-free survival (21.96 ± 3.5 and 23.44 ± 2.5 months; P = 0.275), and overall survival rates (25.76 ± 3.5 and 23.57 ± 2.4 months; P = 0.646). However, differences in pathological downstaging (pT3-pT4, 21.58% and 16.42% for groups 1 and 2, respectively; P < 0.001) and perioperative mortality (6 vs. 0 deaths in groups 1 and 2; respectively) were significant between groups. Conclusion: Neoadjuvant chemotherapy may result in pathological downstaging while having no effects on progression-free or overall survival rates.
Özet
Aim: To evaluate the effect of neoadjuvant chemotherapy on tumor pathology and patient survival in patients with muscle-invasive bladder cancer undergoing radical cystectomy. Neoadjuvant chemotherapy is believed to prevent micrometastasis and provide pathological downstaging. Materials and methods: Between June 2004 and March 2009, 74 patients with muscle-invasive bladder cancer were treated with radical cystectomy. Patients fit to receive chemotherapy were administered systemic chemotherapy of methotrexate, vinblastine, Adriamycin, and cisplatin (MVAC); gemcitabine and cisplatin (GC); or carboplatin and gemcitabine (CG). Patients in Group 1 (n = 36) did not receive any chemotherapy, while the remaining 38 patients in Group 2 did so, before radical cystectomy. Patient characteristics, pathological staging, and survival analysis were compared statistically between groups. Results: The mean follow-up time was 16.12 ± 12.13 months. There was no significant difference between the groups regarding patient age, sex, preoperative clinical staging, lymph node invasion, comorbidity, type of urinary diversions done, postoperative early complications, progression-free survival (21.96 ± 3.5 and 23.44 ± 2.5 months; P = 0.275), and overall survival rates (25.76 ± 3.5 and 23.57 ± 2.4 months; P = 0.646). However, differences in pathological downstaging (pT3-pT4, 21.58% and 16.42% for groups 1 and 2, respectively; P < 0.001) and perioperative mortality (6 vs. 0 deaths in groups 1 and 2; respectively) were significant between groups. Conclusion: Neoadjuvant chemotherapy may result in pathological downstaging while having no effects on progression-free or overall survival rates.