Oncologic Outcomes and Survival in pT0 Tumors After Radical Cystectomy in Patients Without Neoadjuvant Chemotherapy: Results from a Large Multicentre Collaborative Study

Rouprêt, Morgan; Drouin, S.; Larré, S.; Botto, Henry; Hitier, M.; Rigaud, J.; Crew, Jeremy; Xylinas, Évanguelos; Salomon, Laurent; Cornu, Jean‐Nicolas; Iborra, François; Champetier, D.; Rozet, François; Flamand, V.; Bastide, C.; Cormier, L.; Durand, Xavier; Lunardi, P.; Rischmann, P.; Nouhaud, François-Xavier; Ferlicot, Sophie; Patard, Jean‐Jacques; Floch, Aurélie Paule; Irani, Jacques; Peyronnet, B.; Bensalah, Karim; Poissonnier, L.; Grès, Pascal; Droupy, S.; Casenave, J.; Wallerand, Hervé; Soulié, M.; Pfister, Christian

doi:10.1245/s10434-011-1824-y

Cited by 12 publications

(6 citation statements)

References 23 publications

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“…Clinical stage was also not found to be associated with OS in a multi-institutional series. 19 Our study has several limitations. It is a retrospective analysis, with accompanying inherent bias.…”

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confidence: 91%

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Outcomes of pT0N0 at radical cystectomy: The Canadian Bladder Cancer Network experience

Sandhu¹,

Aprikian²,

Chin³

et al. 2012

CUAJ

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Introduction: Radical cystectomy is the standard treatment for muscle invasive bladder cancer. We assessed clinical outcomes in patients found to have no evidence of disease (i.e., pT0N0) following radical cystectomy. Methods: We collected and pooled a database of 2287 patients who underwent radical cystectomy between 1993 and 2008 in eight centres across Canada. Of this number, 135 patients were found to have pT0N0 bladder cancer at the time of cystectomy. Survival data and prognostic variables were analyzed using KaplanMeier method and Cox proportional hazard regression analysis. Results: Median patient age was 66 years with a mean follow-up of 42 months. Clinical stage distribution was Tis 8.9%, Ta 1.5%, T1 20.7%, T2 45.2%, T3 5.2%, and T4 5.2%. The five-year recurrence-free survival (RFS), disease-specific survival (DSS) and overall survival (OS) were 83%, 96%, and 88%, respectively. The 10-year RFS, DSS and OS were 66%, 92%, and 70%, respectively. On Cox proportional regression analysis, no variables were associated with disease recurrence and only patient age was associated with overall survival. Interpretation: Patients with pT0N0 pathology after cystectomy have excellent outcomes with high five-and 10-year RFS, DSS and OS. However, there is still a risk of tumour recurrence in this patient population and thus postoperative surveillance is still required.

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confidence: 91%

“…18 Multiinstitutional reviews have also found that female gender, posterior tumour location and absence of lymph node dissection are associated with increased disease recurrence. 17,19 These patients may benefit from more stringent surveillance to allow identification of recurrence earlier with subsequent initiation of additional therapy.…”

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confidence: 99%

Outcomes of pT0N0 at radical cystectomy: The Canadian Bladder Cancer Network experience

Sandhu¹,

Aprikian²,

Chin³

et al. 2012

CUAJ

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“…There is no definitive evidence regarding the recurrence rate after RC. In particular, the definition of local and distant recurrence is not standardized, the recurrence-free survival (RFS) is highly variable and the specific timing of recurrence is not well defined across the published series [ 2 – 5 ]. Several factors have been variously associated with recurrence after RC.…”

Section: Introductionmentioning

confidence: 99%

Patterns and predictors of recurrence after open radical cystectomy for bladder cancer: a comprehensive review of the literature

et al. 2017

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PurposeTo review the currently available literature reporting the patterns of recurrence and their predictive factors after open radical cystectomy (RC) for bladder cancer.MethodsA review of the literature was performed using the MEDLINE, Scopus and Web of Sciences databases from January 1997 to May 2017. The PRISMA guidelines were followed for the conduct of the study.ResultsLocal recurrence rate ranges between 30 and 54%. Distant recurrence is not often standardized and is reported in up to 50% of cases. The overall 5-year recurrence-free survival rates from 58 to 81%. The mean follow-up of studies included in the analysis ranged from 18 to 350 months. Details on the most important demographic and epidemiological, clinical, histologic and pathologic predictors of recurrence after radical cystectomy are provided through an evidence-based approach. The impact of the extension of lymph node dissection on recurrence after RC is investigated.ConclusionsA correct prognostic assessment is essential for patients undergoing radical cystectomy for bladder cancer, thereby potentially improving their oncologic outcomes.Electronic supplementary materialThe online version of this article (10.1007/s00345-017-2115-4) contains supplementary material, which is available to authorized users.

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“…Treatment with neoadjuvant chemotherapy (NAC) in muscle invasive bladder cancer (MIBC) is associated with clinical benefit in urothelial carcinoma. Cisplatin-based NAC prior to extirpative surgery confers a 6-8% overall survival (OS) benefit compared to surgery alone [1]. Historically, the two most commonly utilized regimens include dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (dd-MVAC) or gemcitabine and cisplatin (GC), with pathological complete response (pT0) after NAC at the time of surgery being widely adopted as a surrogate end point for improved overall survival.…”

Section: Introductionmentioning

confidence: 99%

Role of Gut Microbiome in Neoadjuvant Chemotherapy Response in Urothelial Carcinoma: A Multi-Institutional Prospective Cohort Evaluation

Bukavina

Ginwala

Sindhani

et al. 2023

Preprint

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Treatment with neoadjuvant chemotherapy (NAC) in muscle invasive bladder cancer (MIBC) is associated with clinical benefit in urothelial carcinoma. While extensive research evaluating role of tumor mutational expression profiles and clinicopathologic factors into chemoresponse has been published, the role of gut microbiome (GM) in bladder cancer in chemoresponse has not been thoroughly evaluated. A working knowledge of the microbiome and its effect on all forms of cancer therapy in BC is critical. Here we examine gut microbiome of bladder cancer patients undergoing NAC. Overall, there was no significant difference in alpha and beta diversity by responder status. However, analysis of fecal microbiome samples showed that a higher abundance of Bacteroides within both institutional cohorts during NAC was associated with residual disease at the time of radical cystectomy regardless of chemotherapy regimen. Group community analysis revealed presence of favorable microbial subtypes in complete responders. Finally, fecal microbial composition outperformed clinical variables in prediction of complete response (AUC 0.88 vs AUC 0.50), however, no single microbial species could be regarded as a fully consistent biomarker. Microbiome-based community signature as compared to single microbial species is more likely to be associated as the link between bacterial composition and NAC response.

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Oncologic Outcomes and Survival in pT0 Tumors After Radical Cystectomy in Patients Without Neoadjuvant Chemotherapy: Results from a Large Multicentre Collaborative Study

Abstract: Despite acceptable oncological outcomes, patients with a pT0 tumor at the time of RC are still at risk of recurrence and progression and should not be considered to be entirely cured. In this population, stringent follow-up according to current recommendations should be effective.

Cited by 12 publications

References 23 publications

Outcomes of pT0N0 at radical cystectomy: The Canadian Bladder Cancer Network experience

Outcomes of pT0N0 at radical cystectomy: The Canadian Bladder Cancer Network experience

Patterns and predictors of recurrence after open radical cystectomy for bladder cancer: a comprehensive review of the literature

Role of Gut Microbiome in Neoadjuvant Chemotherapy Response in Urothelial Carcinoma: A Multi-Institutional Prospective Cohort Evaluation

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