Prognostic pathological factors in radical cystectomy after neoadjuvant chemotherapy

Brimo, Fadi; Downes, Michelle; Jamaspishvili, Tamara; Berman, David M.; Barkan, Güliz A.; Athanazio, Daniel Abensur; Abro, Schuharazad; Visram, Kash; Yilmaz, Aslı; Solanki, Shraddha; Hahn, E. G.; Siemens, Robert; Kassouf, Wassim; Trpkov, Kiril

doi:10.1111/his.13654

Cited by 13 publications

(9 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, we considered the relationship between NAC and LVI. Although there was no report that evaluated LVI before and after total resection as in this study, some reports discussed that the presence or absence of LVI after NAC became a prognostic factor in bladder cancer and other cancers [33][34][35]. In this study, there was no significant difference in the disappearance of LVI at RC according to the use of NAC in the LVI+ group at first TURBT (p = 0.282).…”

Section: Discussioncontrasting

confidence: 51%

Impact of Lymphovascular Invasion on Prognosis in the Patients with Bladder Cancer—Comparison of Transurethral Resection and Radical Cystectomy

et al. 2021

View full text Add to dashboard Cite

(1) Background: This study aimed to evaluate the associations of lymphovascular invasion (LVI) at first transurethral resection of bladder (TURBT) and radical cystectomy (RC) with survival outcomes, and to evaluate the concordance between LVI at first TURBT and RC. (2) Methods: We analyzed 216 patients who underwent first TURBT and 64 patients who underwent RC at Toho University Sakura Medical Center. (3) Results: LVI was identified in 22.7% of patients who underwent first TURBT, and in 32.8% of patients who underwent RC. Univariate analysis identified ≥cT3, metastasis and LVI at first TURBT as factors significantly associated with overall survival (OS) and cancer-specific survival (CSS). Multivariate analysis identified metastasis (hazard ratio (HR) 6.560, p = 0.009) and LVI at first TURBT (HR 9.205, p = 0.003) as significant predictors of CSS. On the other hand, in patients who underwent RC, ≥pT3, presence of G3 and LVI was significantly associated with OS and CSS in univariate analysis. Multivariate analysis identified inclusion of G3 as a significant predictor of OS and CSS. The concordance rate between LVI at first TURBT and RC was 48.0%. Patients with positive results for LVI at first TURBT and RC displayed poorer prognosis than other patients (p < 0.05). (4) Conclusions: We found that the combination of LVI at first TURBT and RC was likely to provide a more significant prognostic factor.

show abstract

Section: Discussioncontrasting

confidence: 51%

Impact of Lymphovascular Invasion on Prognosis in the Patients with Bladder Cancer—Comparison of Transurethral Resection and Radical Cystectomy

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Our findings may be in contrast to another study investigating the prognostic value of TRG in muscle-invasive bladder cancer. 16 This multicenter study by Brimo and colleagues also identified TRGs as a prognostic parameter in univariable analyses, but this was not confirmed in multivariable analysis. However, there are some important differences between the study of Brimo and colleagues and our study.…”

Section: Discussionmentioning

confidence: 89%

“…First, our sample size met the requirement of the power calculation, while the study of Brimo and colleagues may have been underpowered (n = 165). Moreover, we excluded aggressive histomorphologic variants, in line with the large randomized controlled trials on neoadjuvant chemotherapy in muscle-invasive bladder cancer, 17,18 whereas Brimo et al 16 did not. 16 Taken together, our study provided a multicenter validation of the prognostic significance of TRG in muscleinvasive bladder cancer after neoadjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Multicenter Validation of Histopathologic Tumor Regression Grade After Neoadjuvant Chemotherapy in Muscle-invasive Bladder Carcinoma

Voskuilen¹,

Genitsch

et al. 2019

American Journal of Surgical Pathology

View full text Add to dashboard Cite

Response classification after neoadjuvant chemotherapy in muscle-invasive bladder carcinoma is based on the TNM stage at radical cystectomy. We recently showed that histopathologic tumor regression grades (TRGs) add prognostic information to TNM. Our aim was to validate the prognostic significance of TRG in muscle-invasive bladder cancer in a multicenter setting. We enrolled 389 patients who underwent cisplatin-based chemotherapy before radical cystectomy in 8 centers between 2010 and 2016. Median follow-up was 2.2 years. TRG was determined in radical cystectomy specimens by local pathologists. Central pathology review was conducted in 20% of cases, which were randomly selected. The major response was defined as ≤ pT1N0. The remaining patients were grouped into partial responders ( ≥ ypT2N0-3 and TRG 2) and nonresponders ( ≥ ypT2N0-3 and TRG 3). TRG was successfully determined in all cases, and interobserver agreement in central pathology review was high (κ = 0.83). After combining TRG and TNM, 47%, 15%, and 38% of patients were major, partial, and nonresponders, respectively. Combination of TRG and TNM showed significant prognostic discrimination of overall survival (major responder: reference; partial responder: hazard ratio 3.5 [95% confidence interval: 1.8-6.8]; nonresponder: hazard ratio 6.1 [95% confidence interval: 3.6-10.3]). This discrimination was superior compared with TNM staging alone, supported by 2 goodnessof-fit criteria (P = 0.041). TRG is a simple, reproducible histopathologic measurement of response to neoadjuvant chemotherapy in muscle-invasive bladder cancer. Integrating TRG with TNM staging resulted in significantly better prognostic stratification than TNM staging alone.

show abstract

mentioning

confidence: 99%

“…Sir: We read with interest the report by Brimo questioning the relevance of tumour regression grade (TRG) after neoadjuvant chemotherapy (NAC) and cystectomy in patients with muscle-invasive bladder cancer. 1 Whereas classic prognosticators such as T stage, N stage and margin status have been shown to be independent predictors of survival, this is not the case for TRG of the primary tumour (TRG PT ). However, the informative nature of TRG PT may be impacted on by the influence of transurethral resection in the primary tumour (PT).…”

mentioning

confidence: 99%

Comment on “Prognostic pathological factors in radical cystectomy after neoadjuvant chemotherapy”

2019

View full text Add to dashboard Cite

Prognostic pathological factors in radical cystectomy after neoadjuvant chemotherapy

Abstract: We confirm that the traditional and routinely reported histological parameters in RC post-NAC remain the most powerful prognosticators of disease course. The significance of TRG in the bladder remains unconfirmed.

Cited by 13 publications

References 27 publications

Impact of Lymphovascular Invasion on Prognosis in the Patients with Bladder Cancer—Comparison of Transurethral Resection and Radical Cystectomy

Impact of Lymphovascular Invasion on Prognosis in the Patients with Bladder Cancer—Comparison of Transurethral Resection and Radical Cystectomy

Multicenter Validation of Histopathologic Tumor Regression Grade After Neoadjuvant Chemotherapy in Muscle-invasive Bladder Carcinoma

Comment on “Prognostic pathological factors in radical cystectomy after neoadjuvant chemotherapy”

Contact Info

Product

Resources

About