| Added by | mollevi |
|---|---|
| Last modified by | celine.gongora |
| Group name | EquipeCG |
| Item Type | Journal Article |
| Title | Adjuvant Chemotherapy After Radical Cystectomy for Urothelial Bladder Cancer: Outcome and Prognostic Factors for Survival in a French Multicenter, Contemporary Cohort |
| Creator | Pouessel et al. |
| Author | D. Pouessel |
| Author | S. Bastuji-Garin |
| Author | N. Houede |
| Author | D. Vordos |
| Author | Y. Loriot |
| Author | C. Chevreau |
| Author | E. Sevin |
| Author | P. Beuzeboc |
| Author | A. Taille |
| Author | A. Le Thuaut |
| Author | Y. Allory |
| Author | S. Culine |
| Abstract | BACKGROUND: In the past decade, adjuvant chemotherapy (AC) after radical cystectomy (RC) was preferred worldwide for patients with muscle-invasive urothelial bladder cancer. In this study we aimed to determine the outcome of patients who received AC and evaluated prognostic factors associated with survival. PATIENTS AND METHODS: We retrospectively analyzed 226 consecutive patients treated in 6 academic hospitals between 2000 and 2009. Multivariate Cox proportional hazards regression adjusted for center to estimate adjusted hazard ratios (HRs) with 95% confidence intervals were used. RESULTS: The median age was 62.4 (range, 35-82) years. Patients had pT3/pT4 and/or pN+ in 180 (79.6%) and 168 patients (74.3%), respectively. Median lymph node (LN) density was 25% (range, 3.1-100). Median time between RC and AC was 61.5 (range, 18-162) days. Gemcitabine with cisplatin, gemcitabine with carboplatin, and MVAC (methotrexate, vinblastine, doxorubicin, and cisplatin) regimens were delivered in 161 (71.2%), 49 (21.7%), and 12 patients (5.3%) of patients, respectively. The median number of cycles was 4 (range, 1-6). Thirteen patients (5.7%) with LN metastases also received adjuvant pelvic radiotherapy (ART). After a median follow-up of 4.2 years, 5-year overall survival (OS) was 40.7%. In multivariate analysis, pT >/=3 stage (HR, 1.73; P = .05), LN density >50% (HR, 1.94; P = .03), and number of AC cycles <4 (HR, 4.26; P = .001) were adverse prognostic factors for OS. ART (HR, 0.30; P = .05) tended to provide survival benefit. CONCLUSION: Classical prognostic features associated with survival are not modified by the use of AC. Patients who derived benefit from AC had a low LN density and received at least 4 cycles of treatment. |
| Publication | Clin Genitourin Cancer |
| Date | Jul 21 2016 |
| Journal Abbr | Clinical genitourinary cancer |
| DOI | 10.1016/j.clgc.2016.07.012 |
| ISSN | 1938-0682 (Electronic) 1558-7673 (Linking) |
| Tags | clinic |
| Date Added | 2018/07/20 - 10:05:58 |
| Date Modified | 2019/05/14 - 15:16:05 |
| Notes and Attachments | (Note) (Note) 27554584 (Attachment) |
Institut de Recherche en Cancérologie de
