TY - JOUR
T1 - Three vs. Four Cycles of Neoadjuvant Chemotherapy for Localized Muscle Invasive Bladder Cancer Undergoing Radical Cystectomy
T2 - A Retrospective Multi-Institutional Analysis
AU - Ferro, Matteo
AU - de Cobelli, Ottavio
AU - Musi, Gennaro
AU - Lucarelli, Giuseppe
AU - Terracciano, Daniela
AU - Pacella, Daniela
AU - Muto, Tommaso
AU - Porreca, Angelo
AU - Busetto, Gian Maria
AU - Del Giudice, Francesco
AU - Soria, Francesco
AU - Gontero, Paolo
AU - Cantiello, Francesco
AU - Damiano, Rocco
AU - Crocerossa, Fabio
AU - Farhan, Abdal Rahman Abu
AU - Autorino, Riccardo
AU - Vartolomei, Mihai Dorin
AU - Muto, Matteo
AU - Marchioni, Michele
AU - Mari, Andrea
AU - Scafuri, Luca
AU - Minervini, Andrea
AU - Longo, Nicola
AU - Chiancone, Francesco
AU - Perdona, Sisto
AU - De Placido, Pietro
AU - Verde, Antonio
AU - Catellani, Michele
AU - Luzzago, Stefano
AU - Mistretta, Francesco Alessandro
AU - Ditonno, Pasquale
AU - Caputo, Vincenzo Francesco
AU - Battaglia, Michele
AU - Zamboni, Stefania
AU - Antonelli, Alessandro
AU - Greco, Francesco
AU - Russo, Giorgio Ivan
AU - Hurle, Rodolfo
AU - Crisan, Nicolae
AU - Manfredi, Matteo
AU - Porpiglia, Francesco
AU - Di Lorenzo, Giuseppe
AU - Crocetto, Felice
AU - Buonerba, Carlo
N1 - Copyright © 2021 Ferro, de Cobelli, Musi, Lucarelli, Terracciano, Pacella, Muto, Porreca, Busetto, Del Giudice, Soria, Gontero, Cantiello, Damiano, Crocerossa, Farhan, Autorino, Vartolomei, Muto, Marchioni, Mari, Scafuri, Minervini, Longo, Chiancone, Perdona, De Placido, Verde, Catellani, Luzzago, Mistretta, Ditonno, Caputo, Battaglia, Zamboni, Antonelli, Greco, Russo, Hurle, Crisan, Manfredi, Porpiglia, Di Lorenzo, Crocetto and Buonerba.
PY - 2021
Y1 - 2021
N2 - Background: Three or four cycles of cisplatin-based chemotherapy is the standard neoadjuvant treatment prior to cystectomy in patients with muscle-invasive bladder cancer. Although NCCN guidelines recommend 4 cycles of cisplatin-gemcitabine, three cycles are also commonly administered in clinical practice. In this multicenter retrospective study, we assessed a large and homogenous cohort of patients with urothelial bladder cancer (UBC) treated with three or four cycles of neoadjuvant cisplatin-gemcitabine followed by radical cystectomy, in order to explore whether three vs. four cycles were associated with different outcomes.Methods: Patients with histologically confirmed muscle-invasive UBC included in this retrospective study had to be treated with either 3 (cohort A) or 4 (cohort B) cycles of cisplatin-gemcitabine as neoadjuvant therapy before undergoing radical cystectomy with lymphadenectomy. Outcomes including pathologic downstaging to non-muscle invasive disease, pathologic complete response (defined as absence of disease -ypT0), overall- and cancer-specific- survival as well as time to recurrence were compared between cohorts A vs. B.Results: A total of 219 patients treated at 14 different high-volume Institutions were included in this retrospective study. Patients who received 3 (cohort A) vs. 4 (cohort B) cycles of neoadjuvant cisplatin-gemcitabine were 160 (73,1%) vs. 59 (26,9%).At univariate analysis, the number of neoadjuvant cycles was not associated with either pathologic complete response, pathologic downstaging, time to recurrence, cancer specific, and overall survival. Of note, patients in cohort B vs. A showed a worse non-cancer specific overall survival at univariate analysis (HR= 2.53; 95 CI= 1.05 - 6.10; p=0.046), although this finding was not confirmed at multivariate analysis.Conclusions: Our findings suggest that 3 cycles of cisplatin-gemcitabine may be equally effective, with less long-term toxicity, compared to 4 cycles in the neoadjuvant setting.
AB - Background: Three or four cycles of cisplatin-based chemotherapy is the standard neoadjuvant treatment prior to cystectomy in patients with muscle-invasive bladder cancer. Although NCCN guidelines recommend 4 cycles of cisplatin-gemcitabine, three cycles are also commonly administered in clinical practice. In this multicenter retrospective study, we assessed a large and homogenous cohort of patients with urothelial bladder cancer (UBC) treated with three or four cycles of neoadjuvant cisplatin-gemcitabine followed by radical cystectomy, in order to explore whether three vs. four cycles were associated with different outcomes.Methods: Patients with histologically confirmed muscle-invasive UBC included in this retrospective study had to be treated with either 3 (cohort A) or 4 (cohort B) cycles of cisplatin-gemcitabine as neoadjuvant therapy before undergoing radical cystectomy with lymphadenectomy. Outcomes including pathologic downstaging to non-muscle invasive disease, pathologic complete response (defined as absence of disease -ypT0), overall- and cancer-specific- survival as well as time to recurrence were compared between cohorts A vs. B.Results: A total of 219 patients treated at 14 different high-volume Institutions were included in this retrospective study. Patients who received 3 (cohort A) vs. 4 (cohort B) cycles of neoadjuvant cisplatin-gemcitabine were 160 (73,1%) vs. 59 (26,9%).At univariate analysis, the number of neoadjuvant cycles was not associated with either pathologic complete response, pathologic downstaging, time to recurrence, cancer specific, and overall survival. Of note, patients in cohort B vs. A showed a worse non-cancer specific overall survival at univariate analysis (HR= 2.53; 95 CI= 1.05 - 6.10; p=0.046), although this finding was not confirmed at multivariate analysis.Conclusions: Our findings suggest that 3 cycles of cisplatin-gemcitabine may be equally effective, with less long-term toxicity, compared to 4 cycles in the neoadjuvant setting.
U2 - 10.3389/fonc.2021.651745
DO - 10.3389/fonc.2021.651745
M3 - Article
C2 - 34046347
SN - 2234-943X
VL - 11
SP - 651745
JO - Front. Oncol.
JF - Front. Oncol.
ER -