Einerhand, Sarah M. H. and Black, Anna J. and Zargar, Homayoun and Fairey, Adrian S. and Dinney, Colin P. and Mir, Maria C. and Krabbe, Laura-Maria and Cookson, Michael S. and Jacobson, Niels-Erik and Montgomery, Jeffrey S. and Vasdev, Nikhil and Yu, Evan Y. and Xylinas, Evanguelos and Kassouf, Wassim and Dall'Era, Marc A. and Sridhar, Srikala S. and McGrath, Jonathan S. and Aning, Jonathan and Shariat, Shahrokh F. and Wright, Jonathan L. and Thorpe, Andrew C. and Morgan, Todd M. and Holzbeierlein, Jeff M. and Bivalacqua, Trinity J. and North, Scott and Barocas, Daniel A. and Lotan, Yair and Grivas, Petros and Garcia, Jorge A. and Stephenson, Andrew J. and Shah, Jay B. and Daneshmand, Siamak and Zargar-Shoshtari, Kamran and Spiess, Philippe E. and van Rhijn, Bas W. G. and Black, Peter C. and Mertens, Laura S. (2022) Multicenter evaluation of neoadjuvant and induction gemcitabine-carboplatin versus gemcitabine-cisplatin followed by radical cystectomy for muscle-invasive bladder cancer. WORLD JOURNAL OF UROLOGY, 40 (11). pp. 2707-2715. ISSN 0724-4983, 1433-8726
Full text not available from this repository. (Request a copy)Abstract
Purpose Cisplatin-based chemotherapy followed by radical cystectomy (RC) is recommended in patients with muscle-invasive bladder cancer (MIBC). However, up to 50% of patients are cisplatin ineligible. The aim of this study was to compare clinical outcomes after >= 3 cycles of preoperative gemcitabine-carboplatin (gem-carbo) versus gemcitabine-cisplatin (gem-cis). Methods We identified 1865 patients treated at 19 centers between 2000 and 2013. Patients were included if they had received >= 3 cycles of neoadjuvant (cT2-4aN0M0) or induction (cTanyN + M0) gem-carbo or gem-cis followed by RC. Results We included 747 patients treated with gem-carbo (n = 147) or gem-cis (n = 600). Patients treated with gem-carbo had a higher Charlson Comorbidity Index (p = 0.016) and more clinically node-positive disease (32% versus 20%; p = 0.013). The complete pathological response (pCR; ypT0N0) rate did not significantly differ between gem-carbo and gem-cis (20.7% versus 22.1%; p = 0.73). Chemotherapeutic regimen was not significantly associated with pCR (OR 0.99 [95%CI 0.61-1.59]; p = 0.96), overall survival (OS) (HR 1.20 [95%CI 0.85-1.67]; p = 0.31), or cancer-specific survival (CSS) (HR 1.35 [95%CI 0.93-1.96]; p = 0.11). Median OS of patients treated with gem-carbo and gem-cis was 28.6 months (95%CI 18.1-39.1) and 45.1 months (95%CI 32.7-57.6) (p = 0.18), respectively. Median CSS of patients treated with gem-carbo and gem-cis was 28.8 months (95%CI 9.8-47.8) and 71.0 months (95%CI median not reached) (p = 0.02), respectively. Subanalyses of the neoadjuvant and induction setting did not show significant survival differences. Conclusion Our results show that a subset of cisplatin-ineligible patients with MIBC achieve pCR on gem-carbo and that survival outcomes seem comparable to gem-cis provided patients are able to receive >= 3 cycles and undergo RC.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | METASTATIC UROTHELIAL CARCINOMA; CHEMOTHERAPY; UNFIT; Bladder; Chemotherapy; Radical cystectomy; Cisplatin; Carboplatin; Neoadjuvant; Urothelial cancer |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Urologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Dec 2023 10:58 |
| Last Modified: | 12 Dec 2023 10:58 |
| URI: | https://pred.uni-regensburg.de/id/eprint/58776 |
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