Pharmacy Medical News about neoadjuvant chemotherapy;completely resected bladder cancer;surgery correlate;survival

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Quality of pathologic response and surgery correlate with survival for patients with completely resected bladder cancer after neoadjuvant chemotherapy
Cancer, 06/15/09

Sonpavde G et al. – Study reports that neoadjuvant chemotherapy (NC) and radical cystectomy (RC) with negative surgical margins for bladder cancer followed by pathologic P0 and LN- disease were found to correlate with improved overall ssurvival (OS). A combination of baseline clinical stage and post-RC pathologic stage may better predict OS.

Methods

A retrospective study to investigate the association of quality of pathologic response after RC with OS
Subjects: subset of S8710 pts who received NC and RC with negative surgical margins

Results

Of 154 pts who received NC, 44.2% were < P2 at RC, 29.9% were P0, and the remainder had P2+ disease or did not undergo RC
In 115 pts who had RC with negative surgical margins, compared with P0 pts, those with residual Pa, P1, or CIS had worse OS
OS was worse for pts with residual P2+ disease
LN-positive (LN+) disease was associated with worse OS than LN-negative (LN-) disease
Pts with LN- disease had inferior OS vs those with 10+ LNs removed
Combination of pre-NC clinical stage and post-RC pathologic stage was predictive of OS

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