The Prognosis and the Role of Adjuvant Chemotherapy for Node-Positive Bladder Cancer Treated with Neoadjuvant Chemotherapy Followed by Surgery
| Autor: | Hyung-Don Kim, Hyehyun Jeong, Jae-Lyun Lee, Kye Jin Park, J.H. Kim, Bumsik Hong, Yongjune Lee, Shinkyo Yoon |
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| Rok vydání: | 2022 |
| Předmět: |
Adult
Male 0301 basic medicine Cancer Research medicine.medical_specialty Adjuvant chemotherapy Urinary bladder neoplasms medicine.medical_treatment Antineoplastic Agents Cystectomy Disease-Free Survival Genitourinary Cancer 03 medical and health sciences 0302 clinical medicine medicine Chemotherapy Humans Lymph node Adjuvant Neoadjuvant therapy Aged Aged 80 and over Lymph node metastasis Bladder cancer business.industry Middle Aged medicine.disease Neoadjuvant Therapy Progression-Free Survival Surgery 030104 developmental biology medicine.anatomical_structure Oncology Lymphatic Metastasis 030220 oncology & carcinogenesis Original Article Female Lymph Cisplatin business |
| Zdroj: | Cancer Research and Treatment : Official Journal of Korean Cancer Association |
| ISSN: | 2005-9256 1598-2998 |
| DOI: | 10.4143/crt.2021.365 |
| Popis: | Purpose This study aims to evaluate the prognosis of pathologically node-positive bladder cancer after neoadjuvant chemotherapy, the role of adjuvant chemotherapy in these patients, and the value of preoperative clinical evaluation for lymph node metastases.Materials and Methods Patients who received neoadjuvant chemotherapy followed by partial/radical cystectomy and had pathologically confirmed lymph node metastases between January 2007 and December 2019 were identified and analyzed.Results A total of 53 patients were included in the study. The median age was 61 years (range, 34 to 81 years) with males comprising 86.8%. Among the 52 patients with post-neoadjuvant/pre-operative computed tomography results, only 33 patients (63.5%) were considered positive for lymph node metastasis. Sixteen patients (30.2%) received adjuvant chemotherapy (AC group), and 37 patients did not (no AC group). With the median follow-up duration of 67.7 months, the median recurrence-free survival (RFS) and the median overall survival (OS) was 8.5 months and 16.2 months, respectively. The 2-year RFS and OS rates were 23.3% and 34.6%, respectively. RFS and OS did not differ between the AC group and no AC group (median RFS, 8.8 months vs. 6.8 months, p=0.772; median OS, 16.1 months vs. 16.3 months, p=0.479). Thirty-eight patients (71.7%) experienced recurrence. Distant metastases were the dominant pattern of failure in both the AC group (91.7%) and no AC group (76.9%).Conclusion Patients with lymph node-positive disease after neoadjuvant chemotherapy followed by surgery showed high recurrence rates with limited survival outcomes. Little benefit was observed with the addition of adjuvant chemotherapy. |
| Databáze: | OpenAIRE |
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