Survival benefit of neoadjuvant chemotherapy in pathologic T2N0 or lower urothelial carcinoma patients: evidence to support the use of neoadjuvant chemotherapy

Translational Andrology and Urology
Hyeong Dong YukJa Hyeon Ku

Abstract

To evaluate the survival benefit of neoadjuvant chemotherapy (NAC) in pathologic T2N0 or less patients. A total of 526 patients with less than pT2N0 underwent radical cystectomy. Patients were divided into three groups: non-NAC, those who did not receive NAC; partial NAC, those who received less 3 cycles of NAC; and complete NAC, those who received 3 cycles of NAC. Median follow up was 74.6 (range, 24-311) months. Recurrent-free survival (RFS) was significantly (P=0.041) higher in the non-NAC group than that in the complete NAC group. Overall survival (OS) was significantly (P=0.039) higher in the non-NAC group than that in the complete NAC group. There was no significant difference between the partial NAC group and the complete NAC group. In patients with pT0, the NAC group had higher pT0 ratio than the non-NAC group (33.3% vs. 21.1%). A total of 66.6% of NAC patients were down-staged to less than T2. In univariate and multivariate analyses, recurrence was significantly related to pathologic T stage (P<0.001), concurrent carcinoma in situ (CIS) (P=0.002), and the number of removed lymph nodes (LNs) (P=0.001). Survival was significantly related to pathologic T stage (P<0.001), lymphovascular invasion (LVI) (P=0.002), the number...Continue Reading

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