Jong Chul Park1, Nilay M Gandhi2, Michael A Carducci3, Mario A Eisenberger3, Alexander S Baras4, George J Netto4, Jen-Jane Liu2, Charles G Drake5, Mark P Schoenberg6, Trinity J Bivalacqua2, Noah M Hahn7. 1. Department of Oncology, Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland. 2. Department of Urology, Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland. 3. Department of Oncology, Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland; Department of Urology, Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland. 4. Department of Pathology, Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland. 5. Department of Oncology, Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland; Department of Urology, Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland; Department of Immunology, Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland. 6. Department of Urology, Montefiore Medical Center and Albert Einstein College of Medicine, New York, New York. 7. Department of Oncology, Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland; Department of Urology, Johns Hopkins University Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland. Electronic address: nhahn4@jhmi.edu.
Abstract
PURPOSE: We determine the impact of the timing of radical cystectomy from the diagnosis of muscle invasive bladder cancer on survival in patients also treated with neoadjuvant chemotherapy. MATERIALS AND METHODS: We performed a retrospective chart review of consecutive patients with muscle invasive bladder cancer who received neoadjuvant chemotherapy followed by cystectomy between 1996 and 2014 at a single institution. Cox proportional hazards regression models were used to investigate the effect of treatment time intervals on overall survival. Three treatment intervals were analyzed for survival impact, from diagnosis of muscle invasive bladder cancer to initiation of neoadjuvant chemotherapy, from initiation of neoadjuvant chemotherapy to cystectomy and from diagnosis to cystectomy. Other pretreatment and posttreatment clinicopathological parameters were also analyzed. RESULTS: Median time from the diagnosis of muscle invasive bladder cancer to radical cystectomy was 28 weeks. Cystectomy performed less than 28 weeks from the diagnosis did not result in significant improvement in overall survival outcomes (HR 0.68, 95% CI 0.28-1.63, p=0.388). Neither the timing of neoadjuvant chemotherapy initiation from diagnosis (median 6 weeks) nor the timing of cystectomy from neoadjuvant chemotherapy initiation (median 22 weeks) was associated with survival. Patient age, variant histology, extravesical and/or lymph node involvement (T3-4 and/or N1 or greater) were significantly associated with survival. CONCLUSIONS: The timing of radical cystectomy in relation to muscle invasive bladder cancer diagnosis date does not significantly impact overall survival in patients with muscle invasive bladder cancer receiving neoadjuvant chemotherapy.
PURPOSE: We determine the impact of the timing of radical cystectomy from the diagnosis of muscle invasive bladder cancer on survival in patients also treated with neoadjuvant chemotherapy. MATERIALS AND METHODS: We performed a retrospective chart review of consecutive patients with muscle invasive bladder cancer who received neoadjuvant chemotherapy followed by cystectomy between 1996 and 2014 at a single institution. Cox proportional hazards regression models were used to investigate the effect of treatment time intervals on overall survival. Three treatment intervals were analyzed for survival impact, from diagnosis of muscle invasive bladder cancer to initiation of neoadjuvant chemotherapy, from initiation of neoadjuvant chemotherapy to cystectomy and from diagnosis to cystectomy. Other pretreatment and posttreatment clinicopathological parameters were also analyzed. RESULTS: Median time from the diagnosis of muscle invasive bladder cancer to radical cystectomy was 28 weeks. Cystectomy performed less than 28 weeks from the diagnosis did not result in significant improvement in overall survival outcomes (HR 0.68, 95% CI 0.28-1.63, p=0.388). Neither the timing of neoadjuvant chemotherapy initiation from diagnosis (median 6 weeks) nor the timing of cystectomy from neoadjuvant chemotherapy initiation (median 22 weeks) was associated with survival. Patient age, variant histology, extravesical and/or lymph node involvement (T3-4 and/or N1 or greater) were significantly associated with survival. CONCLUSIONS: The timing of radical cystectomy in relation to muscle invasive bladder cancer diagnosis date does not significantly impact overall survival in patients with muscle invasive bladder cancer receiving neoadjuvant chemotherapy.
Authors: Albert Font; Raquel Luque; José Carlos Villa; Montse Domenech; Sergio Vázquez; Enrique Gallardo; Juan Antonio Virizuela; Carmen Beato; Rafael Morales-Barrera; Antoni Gelabert; Sonia Maciá; Javier Puente; Gustavo Rubio; Xavier Maldonado; Begoña Perez-Valderrama; Alvaro Pinto; Ovidio Fernández Calvo; Enrique Grande; Javier Garde-Noguera; Eva Fernández-Parra; José Ángel Arranz Journal: Target Oncol Date: 2019-02 Impact factor: 4.493
Authors: Friedrich-Carl von Rundstedt; Douglas A Mata; Oleksandr N Kryvenko; Anup A Shah; Iny Jhun; Seth P Lerner Journal: Bladder Cancer Date: 2017-01-27
Authors: Benjamin W Fischer-Valuck; Jeff M Michalski; Joanna G Harton; Alison Birtle; John P Christodouleas; Jason A Efstathiou; Vivek K Arora; Eric H Kim; Eric M Knoche; Russell K Pachynski; Joel Picus; Yuan James Rao; Melissa Reimers; Bruce J Roth; Paul Sargos; Zachary L Smith; Mohamed S Zaghloul; Hiram A Gay; Sagar A Patel; Brian C Baumann Journal: Clin Genitourin Cancer Date: 2020-06-22 Impact factor: 2.872
Authors: Arie Carneiro; Marcelo Langer Wroclawski; Bruno Nahar; Andrey Soares; Ana Paula Cardoso; Nam Jin Kim; Fabricio Torres Carvalho Journal: Int Braz J Urol Date: 2020 Jul-Aug Impact factor: 1.541
Authors: Nikhil V Kotha; Abhishek Kumar; Tyler J Nelson; Edmund M Qiao; Alex S Qian; Rohith S Voora; Rana R McKay; Brent S Rose; Tyler F Stewart Journal: Urol Oncol Date: 2022-02-23 Impact factor: 2.954