Carboplatin-based adjuvant chemotherapy versus observation after radical cystectomy in patients with pN1-3 urothelial bladder cancer

Afferi, Luca; Lonati, Chiara; Montorsi, Francesco; Briganti, Alberto; Necchi, Andrea; Mari, Andrea; Minervini, Andrea; Campi, Riccardo; Trapani, Ettore Di; Cobelli, O. De; Karnes, R. Jeffrey; Ahmed, Mohamed E.; Mir, Maria Carmen; Algarra, Maria Asuncion; Rink, Michael; Zamboni, Stefania; Simeone, Claudio; Krajewski, Wojciech; Xylinas, Évanguelos; Soria, Francesco; Hendricksen, Kees; Einerhand, Sarah; Mattei, Agostino; Carando, Roberto; Roumiguié, M.; Bajeot, A.; Black, Peter C.; Shariat, Shahrokh F.; Moschini, Marco

doi:10.1007/s00345-022-03948-x

Cited by 4 publications

(2 citation statements)

References 34 publications

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“…In this study, we found a possible benefit of AC only in patients with pN1. Although several reports have investigated the outcomes of AC, 10,11,18,19 these trials did not perform a subgroup analysis of the subdivided pathological lymph node status. To our knowledge, this is the first report that has focused on the correlation between pathological node status (pN0 vs. pN1 vs. pN2–3) and AC efficacy.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of adjuvant chemotherapy for patients who undergo radical cystectomy without neoadjuvant chemotherapy: A retrospective cohort study of 115 advanced bladder cancer patients with pathological lymph node classification

Sakura,

Yamashita,

Notsu

et al. 2024

Int J of Urology

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ObjectivesWe investigated the clinical outcomes of radical cystectomy without cisplatin‐based neoadjuvant chemotherapy (NAC) and identified factors affecting the effectiveness of cisplatin‐based adjuvant chemotherapy (AC).MethodsBetween September 2002 and February 2020, 288 bladder cancer patients who did not receive NAC underwent radical cystectomy. We retrospectively analyzed the recurrence rates, primary recurrence sites, recurrence‐free survival (RFS), and overall survival (OS) of 115 advanced bladder cancer patients (pT3–4 or pN1–3) who were divided into the AC and observation groups. Subgroup analysis was performed, focusing on pathological stage.ResultsIn total, 51 patients received AC, and 64 patients were observed. The median follow‐up duration was 95 months. The recurrence rate was lower in the AC group than in the observation group (35.3% vs. 54.7%, p = 0.041). The rate of recurrences in the lymph node area (dissection site and proximal lymph nodes) was lower in the AC group (9.8% vs. 26.6%; p = 0.031). In the subgroup analysis of patients with pN1, the probability of RFS and OS was higher in the AC group than in the observation group. The hazard ratio for RFS and OS was 0.243 (95% confidence interval [CI]: 0.077–0.768) and 0.259 (95% CI: 0.082–0.816), respectively. The 5‐year RFS and OS were significantly higher in the AC group (80.0% and 79.4%) than in the observation group (35.7% and 42.9%; p < 0.008 and p < 0.012, respectively).ConclusionsAC improved RFS and OS in patients with pN1 disease who did not receive NAC and should be considered for this population.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of adjuvant chemotherapy for patients who undergo radical cystectomy without neoadjuvant chemotherapy: A retrospective cohort study of 115 advanced bladder cancer patients with pathological lymph node classification

Sakura,

Yamashita,

Notsu

et al. 2024

Int J of Urology

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“…However, between 28 and 45% of patients may be ineligible for cisplatin-based chemotherapy following radical cystectomy due to impaired renal function [21]. There is insufficient data to recommend adjuvant carboplatin-based chemotherapy for such patients [22]. Summary NAC (MVAC/Gem-Cis) is recommended for cisplatin-eligible MIBC patients.…”

Section: Key Pointsmentioning

confidence: 99%

Evolving systemic management of urothelial cancers

Tan

Alhalabi

et al. 2023

Current Opinion in Oncology

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Purpose of reviewBladder cancer is the 12th most common cancer worldwide. Historically, the systemic management of urothelial carcinoma has been confined to platinum-based chemotherapy. In this review, we discuss the evolving landscape of systemic treatment for urothelial carcinoma. Recent findingsSince 2016, when the Food and Drug Administration approved the first immune checkpoint inhibitor (CPI), programmed cell death 1 and programmed cell death ligand 1 inhibitors have been evaluated in the nonmuscle invasive bladder cancer, localized muscle invasive bladder cancer as well as advanced/ metastatic bladder cancer settings. Newer approved treatments such as fibroblast growth factor receptor (FGFR) inhibitors and antibody--drug conjugates (ADCs) represent second-line and third-line options. These novel treatments are now being assessed in combination as well as with older traditional platinum-based chemotherapy. SummaryNovel therapies continue to improve bladder cancer outcomes. Personalized approach with well validated biomarkers are important to predict response to therapy.

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Patterns of Utilization and Outcomes of Perioperative Chemotherapy in Patients With Locally Advanced-urothelial Bladder Cancer (LABC)-Real World Data From an Indian Tertiary Care Cancer Center

Saravanabavan

Prakash

Joshi

et al. 2023

Clinical Genitourinary Cancer

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Carboplatin-based adjuvant chemotherapy versus observation after radical cystectomy in patients with pN1-3 urothelial bladder cancer

Cited by 4 publications

References 34 publications

Effectiveness of adjuvant chemotherapy for patients who undergo radical cystectomy without neoadjuvant chemotherapy: A retrospective cohort study of 115 advanced bladder cancer patients with pathological lymph node classification

Effectiveness of adjuvant chemotherapy for patients who undergo radical cystectomy without neoadjuvant chemotherapy: A retrospective cohort study of 115 advanced bladder cancer patients with pathological lymph node classification

Evolving systemic management of urothelial cancers

Patterns of Utilization and Outcomes of Perioperative Chemotherapy in Patients With Locally Advanced-urothelial Bladder Cancer (LABC)-Real World Data From an Indian Tertiary Care Cancer Center

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