The importance of clinical stage among patients with a complete pathologic response at radical cystectomy after neoadjuvant chemotherapy

Parker, William P.; Ho, Philip Levy; Boorjian, Stephen A.; Melquist, Jonathan; Thapa, Prabin; Holzbeierlein, Jeffrey M.; Frank, Igor; Kamat, Ashish M.; Lee, Eugene K.

doi:10.1007/s00345-016-1801-y

Cited by 5 publications

(2 citation statements)

References 26 publications

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“…A number of previous studies have demonstrated that the tumor staging of BLCA has a crucial effect on the clinical characteristic of patients [37,38], such as overall survival time, chemotherapy response, and tumor recurrence. In addition, various molecular markers were also identified as important targets for clinical usage [39].…”

Section: Discussionmentioning

confidence: 99%

Integrative Analysis of Genomic and Clinical Data Reveals Intrinsic Characteristics of Bladder Urothelial Carcinoma Progression

Zhou

Guo

2019

Genes

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The progression of bladder cancer is generally a complex and dynamic process, involving a variety of biological factors. Here, we aimed to identify a set of survival-related genes that play an important role in the progression of bladder cancer and uncover their synergistic patterns. Based on the large-scale genomic profiling data and clinical information of 404 bladder cancer patients derived from The Cancer Genome Atlas (TCGA) database, we first discovered 1078 survival-related genes related to their survival states using univariate and multivariate Cox proportional hazardous regression. We then investigated the dynamic changes of the cooperative behaviors of these 1078 genes by analyzing their respective genomic features, including copy number variations, DNA methylations, somatic mutations, and microRNA regulatory networks. Our analyses showed that during the progression of bladder cancer, the biological disorder involving the identified survival-related genes can be reflected by multiple levels of abnormal gene regulation, ranging from genomic alteration to post-transcriptional dysregulation. In particular, the stage-specific co-expression networks of these genes undergo a series of structural variations. Our findings provide useful hints on understanding the underlying complex molecular mechanisms related to the evolution of bladder cancer and offer a new perspective on clinical diagnosis and treatment of bladder cancer.

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Section: Discussionmentioning

confidence: 99%

Integrative Analysis of Genomic and Clinical Data Reveals Intrinsic Characteristics of Bladder Urothelial Carcinoma Progression

Zhou

Guo

2019

Genes

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“…Recently, it was suggested that a less stringent follow-up regimen could be applied to patients with pCR after RC [ 55 ]. However, pT0 did not mean a patient was free of bladder cancer [ 56 ]. Previous studies have shown that pT0 patients have lower disease-specific mortality; nonetheless, there are still pT0 patients who die from bladder cancer [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of 3 and 4 cycles of neoadjuvant gemcitabine and cisplatin for muscle-invasive bladder cancer: a systematic review and meta-analysis

Lu,

Chen,

Cheng

et al. 2023

BMC Cancer

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Background In muscle-invasive bladder cancer (MIBC), neoadjuvant chemotherapy (NAC) combined with radical cystectomy (RC) is critical in reducing disease recurrence, with GC (gemcitabine and cisplatin) being one of the most commonly used NACs. Different GC schedules have been used, but the best neoadjuvant regimen is still unknown. The clinical outcomes of 3 and 4 cycles of neoadjuvant GC are compared in this systematic review and meta-analysis to determine which is best for patients with MIBC. Methods We searched PubMed, Embase, Web of Science, Cochrane Library, CBM, CNKI, WAN FANG DATA, and meeting abstracts to identify relevant studies up to March 2023. Studies that compared 3 and 4 cycles of neoadjuvant GC for MIBC were included. The primary outcomes were pCR, pDS, OS, and CSS. The secondary outcome was recurrence and SAEs. Results A total of 3 studies, with 1091 patients, were included in the final analysis. Patients that received 4 cycles of GC had a higher pCR (OR = 0.66; 95% CI, 0.50–0.87; p = 0.003) and pDS (OR = 0.63; 95% CI, 0.48–0.84; p = 0.002) than those who received 3 cycles. Regarding recurrence rate (OR = 1.23; 95% CI, 0.91–1.65; p = 0.18), there were no appreciable differences between the 3 and 4 cycles of GC. Survival parameters such as OS (HR, 1.35; 95% CI, 0.86–2.12; p = 0.19) and CSS (HR, 1.06; 95% CI, 0.82–1.38; p = 0.20) were similar. Only one trial reported on the outcomes of SAEs. And there were no statistically significant differences in thrombocytopenia, infection rate, neutropenic fever, anemia, or decreased renal function between patients. The neutropenia of patients was statistically different (OR = 0.72; 95% CI, 0.52–0.99; p = 0.04). Conclusion The 4-cycle GC regimen was superior to the 3-cycle regimen in only the pCR and pDS results. Survival and recurrence rates were similar between the two regimens. In both treatment regimes, the toxicity profile was manageable. However, due to the inherent drawbacks of retrospective research, this should be regarded with caution.

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Neoadjuvant Chemotherapy vs. Radical Cystectomy in Muscle Invasive Bladder Cancer

Goonewardene

Ventii

Bahl

et al. 2021

Management of Urology

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The importance of clinical stage among patients with a complete pathologic response at radical cystectomy after neoadjuvant chemotherapy

Cited by 5 publications

References 26 publications

Integrative Analysis of Genomic and Clinical Data Reveals Intrinsic Characteristics of Bladder Urothelial Carcinoma Progression

Integrative Analysis of Genomic and Clinical Data Reveals Intrinsic Characteristics of Bladder Urothelial Carcinoma Progression

Comparison of 3 and 4 cycles of neoadjuvant gemcitabine and cisplatin for muscle-invasive bladder cancer: a systematic review and meta-analysis

Neoadjuvant Chemotherapy vs. Radical Cystectomy in Muscle Invasive Bladder Cancer

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