Induction chemotherapy followed by surgery in node positive bladder cancer
Richard P Meijer1, Laura S Mertens2, Bas W van Rhijn2
1Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Urology, University Medical Center Utrecht, The Netherlands.
Urology
|November 20, 2013
Summary
Prognosis for node positive bladder cancer (NPBC) remains poor, but induction chemotherapy offers survival benefits for patients achieving a complete pathologic response. Response to chemotherapy predicts outcomes in NPBC patients.
Area of Science:
- Uro-oncology
- Medical oncology
- Clinical research
Background:
- Node positive bladder cancer (NPBC) presents a significant clinical challenge.
- Optimizing treatment strategies for NPBC is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the survival outcomes and prognostic factors in patients with NPBC.
- To assess the impact of induction chemotherapy on patients with NPBC.
Main Methods:
- Retrospective analysis of 149 NPBC patients treated with induction chemotherapy (MVAC, Gem/Cis, or Gem/Carbo) between 1990-2012.
- Evaluation of clinical and pathological response to chemotherapy.
- Cancer-specific survival (CSS) and recurrence-free survival (RFS) were analyzed.
Main Results:
- Median CSS was 20 months, with a 5-year CSS of 29.2%.
- Complete pathologic response (26.8% of patients) was associated with significantly improved CSS (median 127 months, 5-year CSS 63.5%).
- Clinical and pathologic responses were significant predictors of CSS and RFS.
Conclusions:
- Induction chemotherapy offers a survival benefit for a subset of NPBC patients, particularly those achieving complete pathologic response.
- Treatment response assessment is critical for predicting outcomes in NPBC.
- Despite poor overall prognosis, complete pathologic response to induction chemotherapy leads to substantial long-term survival benefits.
