San Diego, CA USA (UroToday.com) The use of neoadjuvant chemotherapy for bladder cancer has shown positive results in past studies; however, no studies have been performed to determine if bladder cancer patients that progressed from non-muscle to muscle invasive bladder cancer respond different to this therapy compared to patients with de novo muscle invasive bladder cancer.
To evaluate this concept, Dr. Pietzak and colleagues performed a retrospective review of patients with clinical stage T2-4aN0M0 urothelial muscle invasive bladder cancer treated with 3-4 cycles of cisplatin-based NAC followed by radical cystectomy and presented their findings.
Of patients from 2001 to 2015, the authors reported a total of 288 patients of which 85% had de novo muscle invasive bladder cancer. Clinical variables such as pathologic response rates after neoadjuvant chemotherapy, overall survival, cancer-specific survival, and recurrence-free survival were evaluated.
Their results of this retrospective study revealed that patients that progressed from non-muscle to muscle invasive bladder cancer had significantly lower pathologic response rate after neoadjuvant therapy but significantly worse overall survival, recurrence-free survival, and cancer specific survival compared to patients with de novo muscle invasive bladder cancer. However this result was not longer significant after adjusting for pathologic T stage. Overall, patients that progressed from non-muscle to muscle invasive bladder cancer were still associated with increased risk of recurrence. The authors concluded from their findings that these patients appear less likely to respond to neoadjuvant therapy compared to patients with de novo muscle invasive bladder cancer.
Presented By: Eugene Pietzak, MD
Written By: Renai Yoon; Research Associate, Department of Urology, University of California, Irvine at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA