| Title |
Concomitant CIS on TURBT does not impact oncological outcomes in patients treated with neoadjuvant or induction chemotherapy followed by radical cystectomy
|
|---|---|
| Published in |
World Journal of Urology, June 2018
|
| DOI | 10.1007/s00345-018-2361-0 |
| Pubmed ID | |
| Authors |
N. Vasdev, H. Zargar, J. P. Noël, R. Veeratterapillay, A. S. Fairey, L. S. Mertens, C. P. Dinney, M. C. Mir, L. M. Krabbe, M. S. Cookson, N. E. Jacobsen, N. M. Gandhi, J. Griffin, J. S. Montgomery, E. Y. Yu, E. Xylinas, N. J. Campain, W. Kassouf, M. A. Dall’Era, J. A. Seah, C. E. Ercole, S. Horenblas, S. S. Sridhar, J. S. McGrath, J. Aning, S. F. Shariat, J. L. Wright, T. M. Morgan, T. J. Bivalacqua, S. North, D. A. Barocas, Y. Lotan, P. Grivas, A. J. Stephenson, J. B. Shah, B. W. van Rhijn, S. Daneshmand, P. E. Spiess, J. M. Holzbeierlein, A. Thorpe, P. C. Black |
| Abstract |
Cisplatin-based neoadjuvant chemotherapy (NAC) for muscle invasive bladder cancer improves all-cause and cancer specific survival. We aimed to evaluate whether the detection of carcinoma in situ (CIS) at the time of initial transurethral resection of bladder tumor (TURBT) has an oncological impact on the response to NAC prior to radical cystectomy. Patients were identified retrospectively from 19 centers who received at least three cycles of NAC or induction chemotherapy for cT2-T4aN0-3M0 urothelial carcinoma of the bladder followed by radical cystectomy between 2000 and 2013. The primary and secondary outcomes were pathological response and overall survival, respectively. Multivariable analysis was performed to determine the independent predictive value of CIS on these outcomes. Of 1213 patients included in the analysis, 21.8% had concomitant CIS. Baseline clinical and pathologic characteristics of the 'CIS' versus 'no-CIS' groups were similar. The pathological response did not differ between the two arms when response was defined as pT0N0 (17.9% with CIS vs 21.9% without CIS; p = 0.16) which may indicate that patients with CIS may be less sensitive to NAC or ≤ pT1N0 (42.8% with CIS vs 37.8% without CIS; p = 0.15). On Cox regression model for overall survival for the cN0 cohort, the presence of CIS was not associated with survival (HR 0.86 (95% CI 0.63-1.18; p = 0.35). The presence of LVI (HR 1.41, 95% CI 1.01-1.96; p = 0.04), hydronephrosis (HR 1.63, 95% CI 1.23-2.16; p = 0.001) and use of chemotherapy other than ddMVAC (HR 0.57, 95% CI 0.34-0.94; p = 0.03) were associated with shorter overall survival. For the whole cohort, the presence of CIS was also not associated with survival (HR 1.05 (95% CI 0.82-1.35; p = 0.70). In this multicenter, real-world cohort, CIS status at TURBT did not affect pathologic response to neoadjuvant or induction chemotherapy. This study is limited by its retrospective nature as well as variability in chemotherapy regimens and surveillance regimens. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 27 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 27 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Professor > Associate Professor | 3 | 11% |
| Other | 2 | 7% |
| Student > Bachelor | 2 | 7% |
| Student > Postgraduate | 2 | 7% |
| Researcher | 2 | 7% |
| Other | 6 | 22% |
| Unknown | 10 | 37% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 10 | 37% |
| Arts and Humanities | 1 | 4% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 4% |
| Agricultural and Biological Sciences | 1 | 4% |
| Business, Management and Accounting | 1 | 4% |
| Other | 2 | 7% |
| Unknown | 11 | 41% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 June 2018.
All research outputs
#15,536,861
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Outputs from World Journal of Urology
#1,501
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Outputs of similar age
#209,573
of 329,372 outputs
Outputs of similar age from World Journal of Urology
#45
of 58 outputs
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