Mp26-17 could a history of non-muscle invasive bladder cancer have a prognostic role in ct2-4an0m0 bladder cancer patients treated with radical cystectomy and neoadjuvant chemotherapy?

You have accessJournal of UrologyBladder Cancer: Invasive I (MP26)1 Apr 2019MP26-17 COULD A HISTORY OF NON-MUSCLE INVASIVE BLADDER CANCER HAVE A PROGNOSTIC ROLE IN CT2-4AN0M0 BLADDER CANCER PATIENTS TREATED WITH RADICAL CYSTECTOMY AND NEOADJUVANT CHEMOTHERAPY? Emina Kayama*, Eiji Kikuchi, Kyohei Hakozaki, Nobuyuki Tanaka, Gou Kaneko, Suguru Shirotake, Yasumasa Miyazaki, Shunsuke Yokomine, Maeda Takahiro, Kunimitsu Kanai, Masafumi Oyama, Yosuke Nakajima, Satoshi Hara, Tetsuo Monma, and Mototsugu Oya Emina Kayama*Emina Kayama* More articles by this author , Eiji KikuchiEiji Kikuchi More articles by this author , Kyohei HakozakiKyohei Hakozaki More articles by this author , Nobuyuki TanakaNobuyuki Tanaka More articles by this author , Gou KanekoGou Kaneko More articles by this author , Suguru ShirotakeSuguru Shirotake More articles by this author , Yasumasa MiyazakiYasumasa Miyazaki More articles by this author , Shunsuke YokomineShunsuke Yokomine More articles by this author , Maeda TakahiroMaeda Takahiro More articles by this author , Kunimitsu KanaiKunimitsu Kanai More articles by this author , Masafumi OyamaMasafumi Oyama More articles by this author , Yosuke NakajimaYosuke Nakajima More articles by this author , Satoshi HaraSatoshi Hara More articles by this author , Tetsuo MonmaTetsuo Monma More articles by this author , and Mototsugu OyaMototsugu Oya More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555682.97472.e5AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: We conducted a retrospective study to examine whether a history of non-muscle invasive bladder cancer (NMIBC) plays a prognostic role in radical cystectomy (RC)-treated patients with cT2-T4a muscle invasive bladder cancer (MIBC) without lymph node involvement. We also evaluated whether neoadjuvant chemotherapy may be equally effective in initially diagnosed MIBC patients without a history of NMIBC (i.e. primary MIBC) and those that progressed from NMIBC (i.e. progressive MIBC). METHODS: We identified a total of 282 patients who were diagnosed as cT2-T4aN0M0 bladder cancers, treated with open RC and were having no lymph node involvement at our institutions between 2004 and 2015. We compared the clinic-pathological characteristics and clinical outcome according to the type of MIBC (primary MIBC, N=231 vs progressive MIBC, N=51). RESULTS: The primary MIBC group had 48.1% of patients in cT2, 40.7% in cT3, and 11.3% in cT4, while the progressive MIBC group had 72.5% in cT2, 17.6% in cT3, and 9.8% in cT4 (p=0.004). In overall, the 5-year cancer-specific survival (CSS) rate in progressive MIBC group was 61.6%, which was significantly lower than that in primary MIBC group (76.1%, p=0.005, figure below). Progressive MIBC (Hazard Ratio; HR of 2.170, p=0.008) was independently associated with cancer death. In primary MIBC group, the 5-year CSS rate in patients treated with neoadjuvant chemotherapy was 85.4%, which was significantly higher than those without (71.5%, p=0.023) and multivariate Cox's regression analysis revealed that pathological T3 or more, LN dissected of ≤ 8, and LVI positivity were independently associated with cancer death. In progressive MIBC group, no significantly difference on CSS was observed between patients treated with and without neoadjuvant chemotherapy and pathological T3 or more and a positive surgical margin were independently associated with cancer death. CONCLUSIONS: MIBC progressed from NMIBC had significantly worse clinical outcome as compared to MIBC without a history of NMIBC and might have less efficacy for neoadjuvant chemotherapy. These results would be informative even for NMIBC patients treated with conservative intravesical therapy. Source of Funding: none Tokyo, Japan; Saitama, Japan; Kanagawa, Japan; Saitama, Japan; Kanagawa, Japan; Saitama, Japan; Kanagawa, Japan; Saitama, Japan; Tokyo, Japan© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e360-e360 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emina Kayama* More articles by this author Eiji Kikuchi More articles by this author Kyohei Hakozaki More articles by this author Nobuyuki Tanaka More articles by this author Gou Kaneko More articles by this author Suguru Shirotake More articles by this author Yasumasa Miyazaki More articles by this author Shunsuke Yokomine More articles by this author Maeda Takahiro More articles by this author Kunimitsu Kanai More articles by this author Masafumi Oyama More articles by this author Yosuke Nakajima More articles by this author Satoshi Hara More articles by this author Tetsuo Monma More articles by this author Mototsugu Oya More articles by this author Expand All Advertisement PDF downloadLoading ...