Discerning Patterns and Quality of Neoadjuvant Chemotherapy Use Among Patients with Muscle-invasive Bladder Cancer

Huo, Jinhai; Ray-Zack, Mohamed D.; Shan, Yong; Chamie, Karim; Boorjian, Stephen A.; Kerr, Preston; Jana, Bagi; Freedland, Stephen J.; Kamat, Ashish M.; Mehta, Hemalkumar B.; Williams, Stephen B.

doi:10.1016/j.euo.2018.07.009

Cited by 27 publications

(14 citation statements)

References 35 publications

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“…While concern for developing CKD may contribute to nonutilization of neoadjuvant chemotherapy, we did not demonstrate an increased risk for patients who received cisplatin-based neoadjuvant chemotherapy. While CKD may contribute to patients being ineligible to receive cisplatin, there have been few studies investigating the impact of carboplatin-based neoadjuvant chemotherapy and/or adjuvant chemotherapy on CKD [34] , [35] , [36] . We focused on the 12-mo postoperative timeline as this is the setting in which patients may be recommended to receive adjuvant chemotherapy and found that the majority of patients who do not receive cisplatin in the neoadjuvant settings experience further eGFR decline postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Renal Morbidity Following Radical Cystectomy in Patients with Bladder Cancer

Schmidt

Velaer

Thomas

et al. 2022

European Urology Open Science

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Section: Discussionmentioning

confidence: 99%

Renal Morbidity Following Radical Cystectomy in Patients with Bladder Cancer

Schmidt

Velaer

Thomas

et al. 2022

European Urology Open Science

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“…It is known that NAC prior to RC significantly reduces patient mortality (34,35), however from the current data it is not possible to identify whether the lack of an effect of delay on mortality in those who received NAC is due to the potential beneficial effects of NAC. Furthermore, patients who receive NAC tend to be younger with fewer comorbidities and are therefore already at a survival advantage (36).…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-analysis of Delay in Radical Cystectomy and the Effect on Survival in Bladder Cancer Patients

Russell

Liedberg

Khan

et al. 2020

European Urology Oncology

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“…These include: (i) increased acute toxicity of chemotherapy due to accumulation of metabolites in the obstructed kidney; (ii) increased delayed toxicity or damage to long-term renal function due to the same accumulation; (iii) increased infectious complications due to stagnant urine in an obstructed system or presence of an indwelling drainage device during NAC-induced immunosuppression; (iv) delay in definitive therapy due to need for an ancillary drainage procedure; and (v) complications, pain and inconvenience inherent to the need for an ancillary drainage procedure prior to cystectomy. It has been well established that many patients who are technically eligible for NAC never receive NAC prior to cystectomy [14][15][16]. It is possible that these concerns may explain some of these omissions.…”

Section: Discussionmentioning

confidence: 99%

Safety of neoadjuvant chemotherapy in patients with muscle‐invasive bladder cancer and malignant ureteric obstruction

et al. 2021

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To determine whether patients with carcinoma invading bladder muscle (MIBC) and ureteric obstruction can safely receive cisplatin-based neoadjuvant chemotherapy (C-NAC), and to determine whether such patients require relief of obstruction with a ureteric stent or percutaneous nephrostomy prior to beginning C-NAC. Patients and MethodsWe performed a single-institution retrospective analysis of MIBC patients receiving C-NAC and falling into three groups: no ureteric obstruction (NO); relieved ureteric obstruction (RO); and unrelieved ureteric obstruction (URO). To address whether patients with obstruction can safely receive C-NAC, we compared patients with NO to those with RO, with the primary outcome of premature chemotherapy discontinuation. To investigate whether patients with obstruction should have the obstruction relieved prior to NAC, we compared RO to URO patients using a primary composite outcome of grade ≥ 3 adverse events, premature chemotherapy discontinuation, dose reduction, or dose interruption. The primary outcomes were compared using multivariable logistic regression. Sensitivity analyses were performed for the RO vs URO comparison, in which patients with only mild degrees of obstruction were excluded from the URO group. ResultsA total of 193 patients with NO, 49 with RO, and 35 with URO were analysed. There were no statistically significant differences between those with NO and those with RO in chemotherapy discontinuation (15% vs 22%; P = 0.3) or any secondary outcome. There was no statistically significant difference between those with RO and URO in the primary composite outcome (51% vs 53%; P = 1) or any secondary outcome. ConclusionPatients with ureteric obstruction can safely receive C-NAC. Relief of obstruction was not associated with increased safety of C-NAC delivery.

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Discerning Patterns and Quality of Neoadjuvant Chemotherapy Use Among Patients with Muscle-invasive Bladder Cancer

Cited by 27 publications

References 35 publications

Renal Morbidity Following Radical Cystectomy in Patients with Bladder Cancer

Renal Morbidity Following Radical Cystectomy in Patients with Bladder Cancer

A Systematic Review and Meta-analysis of Delay in Radical Cystectomy and the Effect on Survival in Bladder Cancer Patients

Safety of neoadjuvant chemotherapy in patients with muscle‐invasive bladder cancer and malignant ureteric obstruction

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