Literature DB >> 19517476

Quality of pathologic response and surgery correlate with survival for patients with completely resected bladder cancer after neoadjuvant chemotherapy.

Guru Sonpavde1, Bryan H Goldman, V O Speights, Seth P Lerner, David P Wood, Nicholas J Vogelzang, Donald L Trump, Ronald B Natale, H Barton Grossman, E David Crawford.   

Abstract

BACKGROUND: In a retrospective study of Southwestern Oncology Group (SWOG)-S8710/INT-0080 (radical cystectomy [RC] alone vs 3 cycles of neoadjuvant chemotherapy [NC] with methotrexate, vinblastine, doxorubicin, and cisplatin before RC for bladder cancer), factors found to be associated with improved overall survival (OS) included pathologic complete response, defined as P0; treatment with NC; completion of RC with negative surgical margins; and >or=10 pelvic lymph nodes (LNs) removed.
METHODS: The authors used stratified Cox regression to retrospectively study the association of quality of pathologic response after RC with OS in the subset of S8710 patients who received NC and RC with negative surgical margins.
RESULTS: Of 154 patients who received NC, 68 (44.2%) were <P2 (P0, Pa, P1, or carcinoma in situ [CIS]) at RC, 46 (29.9%) were P0, and the remainder had P2+ disease or did not undergo RC. In 115 patients who had RC with negative surgical margins, compared with P0 patients, those with residual Pa, P1, or CIS appeared to have worse OS (P=.054); OS was significantly worse for patients with residual P2+ disease (P=.0006). LN-positive (LN+) disease was found to be associated with worse OS than LN-negative (LN-) disease (P=.0005). Patients with LN- disease (ie, those with <10 LNs removed) appeared to have inferior OS compared with those with 10+ LNs removed (P=.079). The combination of pre-NC clinical stage and post-RC pathologic stage was found to be predictive of OS (P<.0001).
CONCLUSIONS: NC and RC with negative surgical margins for bladder cancer followed by pathologic P0 and LN- disease were found to correlate with improved OS. A combination of baseline clinical stage and post-RC pathologic stage may better predict OS. Copyright (c) 2009 American Cancer Society.

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Year:  2009        PMID: 19517476      PMCID: PMC3079554          DOI: 10.1002/cncr.24466

Source DB:  PubMed          Journal:  Cancer        ISSN: 0008-543X            Impact factor:   6.860


  24 in total

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3.  Adjuvant cisplatin chemotherapy following cystectomy for bladder cancer: results of a prospective randomized trial.

Authors:  U E Studer; M Bacchi; C Biedermann; P Jaeger; R Kraft; L Mazzucchelli; R Markwalder; E Senn; R W Sonntag
Journal:  J Urol       Date:  1994-07       Impact factor: 7.450

4.  Surgical factors influence bladder cancer outcomes: a cooperative group report.

Authors:  Harry W Herr; James R Faulkner; H Barton Grossman; Ronald B Natale; Ralph deVere White; Michael F Sarosdy; E David Crawford
Journal:  J Clin Oncol       Date:  2004-06-15       Impact factor: 44.544

5.  Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer.

Authors:  H Barton Grossman; Ronald B Natale; Catherine M Tangen; V O Speights; Nicholas J Vogelzang; Donald L Trump; Ralph W deVere White; Michael F Sarosdy; David P Wood; Derek Raghavan; E David Crawford
Journal:  N Engl J Med       Date:  2003-08-28       Impact factor: 91.245

6.  A randomized trial of radical cystectomy versus radical cystectomy plus cisplatin, vinblastine and methotrexate chemotherapy for muscle invasive bladder cancer.

Authors:  F Freiha; J Reese; F M Torti
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7.  Radical cystectomy: extending the limits of pelvic lymph node dissection improves survival for patients with bladder cancer confined to the bladder wall.

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9.  The role of adjuvant chemotherapy following cystectomy for invasive bladder cancer: a prospective comparative trial.

Authors:  D G Skinner; J R Daniels; C A Russell; G Lieskovsky; S D Boyd; P Nichols; W Kern; J Sakamoto; M Krailo; S Groshen
Journal:  J Urol       Date:  1991-03       Impact factor: 7.450

Review 10.  Neoadjuvant chemotherapy in invasive bladder cancer: a systematic review and meta-analysis.

Authors: 
Journal:  Lancet       Date:  2003-06-07       Impact factor: 79.321

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Review 2.  Neoadjuvant chemotherapy for invasive bladder cancer.

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6.  Defects in DNA Repair Genes Confer Improved Long-term Survival after Cisplatin-based Neoadjuvant Chemotherapy for Muscle-invasive Bladder Cancer.

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8.  Circulating Tumor Cells as Potential Biomarkers in Bladder Cancer.

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9.  Immune checkpoint inhibition in upper tract urothelial carcinoma.

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10.  Somatic ERCC2 mutations correlate with cisplatin sensitivity in muscle-invasive urothelial carcinoma.

Authors:  Eliezer M Van Allen; Kent W Mouw; Philip Kim; Gopa Iyer; Nikhil Wagle; Hikmat Al-Ahmadie; Cong Zhu; Irina Ostrovnaya; Gregory V Kryukov; Kevin W O'Connor; John Sfakianos; Ilana Garcia-Grossman; Jaegil Kim; Elizabeth A Guancial; Richard Bambury; Samira Bahl; Namrata Gupta; Deborah Farlow; Angela Qu; Sabina Signoretti; Justine A Barletta; Victor Reuter; Jesse Boehm; Michael Lawrence; Gad Getz; Philip Kantoff; Bernard H Bochner; Toni K Choueiri; Dean F Bajorin; David B Solit; Stacey Gabriel; Alan D'Andrea; Levi A Garraway; Jonathan E Rosenberg
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