Survival outcomes of patients with muscle-invasive bladder cancer according to pathological response at radical cystectomy with or without neo-adjuvant chemotherapy: a case-control matching study

Noor van Ginkel, Tom J. N. Hermans, the Dutch Cystectomy Snapshot Group, Dennie Meijer, Joost L. Boormans, Jens Voortman, Laura Mertens, Sytse C. van Beek, Andre N. Vis

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Abstract

Objectives To assess survival of patients with muscle-invasive bladder cancer (MIBC) who underwent radical cystectomy (RC) with or without neo-adjuvant chemotherapy (NAC) according to the pathological response at RC.Methods 965 patients with MIBC (cT2-4aN0M0) who underwent RC with or without NAC were analyzed. Among the collected data were comorbidity, clinical and pathological tumor stage, tumor grade, nodal status (y)pN, and OS. Case–control matching of 412 patients was performed to compare oncological outcomes. Kaplan–Meier curves were created to estimate OS for patients who underwent RC with or without NAC, and for those with complete response (pCR), partial response (pPR), or residual or progressive disease (PD).
Results Patients with a pCR or pPR at RC, with or without NAC, had better OS than patients who had PD (both p val-
ues < 0.001). Moreover, the incidence of pCR was significantly higher in patients receiving NAC prior to RC than in patients undergoing RC only (31% versus 15%, respectively; p < 0.001). Case–control matching displayed better OS of patients who underwent RC with NAC, median survival not reached, than of those who underwent RC only, median 4.5 years (p = 0.023).
Conclusions This study showed that patients with MIBC who underwent NAC with RC had a significant better OS than those who underwent RC only. The proportion of patients with a pCR was higher in those who received NAC and RC than in those who were treated by RC only. The favorable OS rate in the NAC and RC cohort was probably attributed to the higher observed pCR rate.
Original languageEnglish
Pages (from-to)3145-3152
Number of pages8
JournalInternational Urology and Nephrology
Volume54
Issue number12
DOIs
Publication statusE-pub ahead of print - 23 Aug 2022

Bibliographical note

Funding Information:
The members of the Dutch Cystectomy Snapshot Research Group: KKH Abeng,h, TJ Arendsi, PJ Ausemsj, D Baselmansk, CPAM Bergerl, AC Berrensm, H Bickerstaffen, SD Boso, M Braamp, KT Buddinghj, S Clausq, K Dekkerr, T van Doeverenc, SMH Einerhande, LMCL Fossionk, EJ van Genneps, LA Grondhuis Palaciosl, FJ Hinsenvelda, MM Hobijnu, SH van Huysteeo, M Jaspers-Valentijnn, OS Klaverv, EL Koldewijnq, L Korstenw, A Lentingm, KJ Lentjess, HB Luitingc, S. van der Meerr, JA Nieuwenhuijzena, MA Noordzijt, RI Nooterm, CAW Notenboomc, RJA Oomenw, HG van der Poele, JGH van Roermundv, J de Rooijk, H Roshanij, DKE van der Schootf, BP Schrierr, MA van der Slotv, DM Somfordi, PJ Stelwagena, AMA Strouxu, A van der Westt, BP Wijsmanw, WAKM Windtp, P van Zantenj:fDepartment of Urology, Amphia Hospital, Breda, The Netherlands.gNetherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.hRadboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands.iDepartment of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.jDepartment of Urology, HagaZiekenuis, Den Haag, The Netherlands.kDepartment of Urology, Máxima Medical Centre, Veldhoven, The Netherlands.lDepartment of Urology, Haaglanden Medical Centre, Den Haag, The Netherlands.mDepartment of Urology, Franciscus Hospital, Rotterdam, The Netherlands.nDepartment of Urology, Bravis Hospital, Bergen op Zoom, Roosendaal, The Netherlands.oDepartment of Urology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands.pDepartment of Urology, Martini Hospital, Groningen, The Netherlands.qDepartment of Urology, Catharina Hospital, Eindhoven, The Netherlands.rDepartment of Urology, Jeroen Bosch Hospital, ‘s-Hertogenbosch, The Netherlands.sDepartment of Urology, Leiden University Medical Centre, Leiden, The Netherlands.tDepartment of Urology, Spaarne Gasthuis, Haarlem, Hoofddorp, The Netherlands.uDepartment of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands.vDepartment of Urology, Maasstad Hospital, Rotterdam, The Netherlands.wDepartment of Urology, Elisabeth TweeSteden Hospital, Tilburg, The Netherlands.

Publisher Copyright:
© 2022, The Author(s).

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