Neoadjuvant chemotherapy for patients with muscle-invasive urothelial bladder cancer candidates for curative surgery: A prospective clinical trial based on cisplatin feasibility

Giovanni Schinzari, Francesco Pierconti, Marco Racioppi, Alessandra Cassano, Pierfrancesco Bassi, Santa Monterisi, Giulia Nazzicone, Armando Orlandi, Carlo Antonio Barone

Risultato della ricerca: Contributo in rivistaArticolo in rivista

2 Citazioni (Scopus)

Abstract

Background: Neoadjuvant chemotherapy demonstrated a survival benefit versus cystectomy alone in muscle-invasive urothelial bladder cancer. Despite this advantage, preoperative chemotherapy is not widely employed. When patients are unfit for cisplatin-based regimen, they are often candidates for immediate surgery. In our study, patients with muscle-invasive bladder cancer were treated with neoadjuvant chemotherapy. The principal objective was the rate of complete pathological response (PCR). Secondary end-points were disease-free survival (DFS), overall survival (OS) and toxicity. Patients and Methods: Patients (n=72) with Eastern Cooperative Oncology Group (ECOG) performance status 0-1, clinical stage cT3-4, and/or N+ muscle-invasive bladder cancer were enrolled. The chemotherapy regimen was established according to the cisplatin feasibility. Thirty patients were treated with cisplatin/gemcitabine (Gem) and 42 with carboplatin/Gem. Results: The rate of PCR was 29.2%, 36% with cisplatin-based treatment and 23.8% with carboplatin (p=0.3574). DFS and OS were longer in PCR patients, while no difference was reported between cisplatin/Gem and Carboplatin/Gem groups. Conclusion: Our results confirm the prognostic value of PCR in neoadjuvant chemotherapy for muscle-invasive bladder cancer. When the patients are not fit for cisplatin, a carboplatin/Gem regimen represents a valid option because of comparable long-term outcome. When cisplatin is not feasible, the exclusion of a preoperative treatment is not justified.
Lingua originaleEnglish
pagine (da-a)6453-6458
Numero di pagine6
RivistaAnticancer Research
Volume37
DOI
Stato di pubblicazionePubblicato - 2017

Keywords

  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols
  • Cancer Research
  • Carboplatin
  • Carcinoma, Transitional Cell
  • Cisplatin
  • Cystectomy
  • Deoxycytidine
  • Disease-Free Survival
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoadjuvant
  • Neoadjuvant Therapy
  • Oncology
  • Pathological response
  • Prospective Studies
  • Survival Analysis
  • Treatment Outcome
  • Urinary Bladder Neoplasms
  • Urothelial bladder cancer

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