Abstract
Purpose: To evaluate gemcitabine-cisplatin (GC) neoadjuvant cisplatin-based chemotherapy (NAC) for pathologic response (pR) and cancer-specific outcomes following radical cystectomy (RC) for muscle-invasive bladder cancer and identify clinical parameters associated with pR. Materials and methods: We studied 150 consecutive cases of muscle-invasive bladder cancer that received GC NAC followed by open RC (2000-2013). A cohort of 121 patients treated by RC alone was used for comparison. Pathologic response and cancer-specific survival (CSS) were compared. We created the Johns Hopkins Hospital Dose Index to characterize chemotherapeutic dosing regimens and accurately assess sufficient neoadjuvant dosing regarding patient tolerance. Results: No significant difference was noted in 5-year CSS between GC NAC (58%) and non-NAC cohorts (61%). The median follow-up was 19.6 months (GC NAC) and 106.5 months (non-NAC). Patients with residual non-muscle-invasive disease after GC NAC exhibit similar 5-year CSS relative to patients with no residual carcinoma (P = 0.99). NAC pR (≤pT1) demonstrated improved 5-year CSS rates (90.6% vs. 27.1%, P
| Original language | English (US) |
|---|---|
| Pages (from-to) | 204e1-204e7 |
| Journal | Urologic Oncology: Seminars and Original Investigations |
| Volume | 33 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 1 2015 |
| Externally published | Yes |
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Keywords
- Bladder cancer
- Gemcitabine-cisplatin
- Neoadjuvant chemotherapy
- Pathologic response
- Urothelial carcinoma
ASJC Scopus subject areas
- Oncology
- Urology
Cite this
Gemcitabine and cisplatin neoadjuvant chemotherapy for muscle-invasive urothelial carcinoma : Predicting response and assessing outcomes. / Gandhi, Nilay M.; Baras, Alexander; Munari, Enrico; Faraj, Sheila; Reis, Leonardo O.; Liu, Jen-Jane; Kates, Max; Hoque, Mohammad Obaidul; Berman, David; Hahn, Noah M.; Eisenberger, Mario; Netto, George J.; Schoenberg, Mark P.; Bivalacqua, Trinity J.
In: Urologic Oncology: Seminars and Original Investigations, Vol. 33, No. 5, 01.05.2015, p. 204e1-204e7.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Gemcitabine and cisplatin neoadjuvant chemotherapy for muscle-invasive urothelial carcinoma
T2 - Predicting response and assessing outcomes
AU - Gandhi, Nilay M.
AU - Baras, Alexander
AU - Munari, Enrico
AU - Faraj, Sheila
AU - Reis, Leonardo O.
AU - Liu, Jen-Jane
AU - Kates, Max
AU - Hoque, Mohammad Obaidul
AU - Berman, David
AU - Hahn, Noah M.
AU - Eisenberger, Mario
AU - Netto, George J.
AU - Schoenberg, Mark P.
AU - Bivalacqua, Trinity J.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Purpose: To evaluate gemcitabine-cisplatin (GC) neoadjuvant cisplatin-based chemotherapy (NAC) for pathologic response (pR) and cancer-specific outcomes following radical cystectomy (RC) for muscle-invasive bladder cancer and identify clinical parameters associated with pR. Materials and methods: We studied 150 consecutive cases of muscle-invasive bladder cancer that received GC NAC followed by open RC (2000-2013). A cohort of 121 patients treated by RC alone was used for comparison. Pathologic response and cancer-specific survival (CSS) were compared. We created the Johns Hopkins Hospital Dose Index to characterize chemotherapeutic dosing regimens and accurately assess sufficient neoadjuvant dosing regarding patient tolerance. Results: No significant difference was noted in 5-year CSS between GC NAC (58%) and non-NAC cohorts (61%). The median follow-up was 19.6 months (GC NAC) and 106.5 months (non-NAC). Patients with residual non-muscle-invasive disease after GC NAC exhibit similar 5-year CSS relative to patients with no residual carcinoma (P = 0.99). NAC pR (≤pT1) demonstrated improved 5-year CSS rates (90.6% vs. 27.1%, P
AB - Purpose: To evaluate gemcitabine-cisplatin (GC) neoadjuvant cisplatin-based chemotherapy (NAC) for pathologic response (pR) and cancer-specific outcomes following radical cystectomy (RC) for muscle-invasive bladder cancer and identify clinical parameters associated with pR. Materials and methods: We studied 150 consecutive cases of muscle-invasive bladder cancer that received GC NAC followed by open RC (2000-2013). A cohort of 121 patients treated by RC alone was used for comparison. Pathologic response and cancer-specific survival (CSS) were compared. We created the Johns Hopkins Hospital Dose Index to characterize chemotherapeutic dosing regimens and accurately assess sufficient neoadjuvant dosing regarding patient tolerance. Results: No significant difference was noted in 5-year CSS between GC NAC (58%) and non-NAC cohorts (61%). The median follow-up was 19.6 months (GC NAC) and 106.5 months (non-NAC). Patients with residual non-muscle-invasive disease after GC NAC exhibit similar 5-year CSS relative to patients with no residual carcinoma (P = 0.99). NAC pR (≤pT1) demonstrated improved 5-year CSS rates (90.6% vs. 27.1%, P
KW - Bladder cancer
KW - Gemcitabine-cisplatin
KW - Neoadjuvant chemotherapy
KW - Pathologic response
KW - Urothelial carcinoma
UR - http://www.scopus.com/inward/record.url?scp=84929264615&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84929264615&partnerID=8YFLogxK
U2 - 10.1016/j.urolonc.2015.02.011
DO - 10.1016/j.urolonc.2015.02.011
M3 - Article
C2 - 25814145
AN - SCOPUS:84929264615
VL - 33
SP - 204e1-204e7
JO - Urologic Oncology: Seminars and Original Investigations
JF - Urologic Oncology: Seminars and Original Investigations
SN - 1078-1439
IS - 5
ER -