Downstaging and survival benefits of neoadjuvant radiotherapy before cystectomy for patients with invasive bladder carcinoma

Granfors, Torvald; Tomić, Radiša; Ljungberg, Börje

doi:10.1080/00365590902854313

Cited by 19 publications

(8 citation statements)

References 21 publications

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“…Results are considered inconclusive, since almost 50% of patients from the largest trial included, did not receive the planned treatment . A more recent single center retrospective study, applying modern radiation techniques reported significant longer OS in patients with cT3 tumors treated with NAR prior to RC . A population‐based study by Diaz et al .…”

Section: Discussionmentioning

confidence: 99%

Superior efficacy of neoadjuvant chemotherapy and radical cystectomy in cT3‐4aN0M0 compared to cT2N0M0 bladder cancer

Hermans

Voskuilen

Deelen

et al. 2018

Intl Journal of Cancer

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In this study, we compared complete pathological downstaging (pCD, ≤(y)pT1N0) and overall survival (OS) in patients with cT2 versus cT3-4aN0M0 UC of the bladder undergoing radical cystectomy (RC) with or without neoadjuvant chemo- (NAC) or radiotherapy (NAR). A population-based sample of 5,517 patients, who underwent upfront RC versus NAC + RC or NAR + RC for cT2-4aN0M0 UC between 1995-2013, was identified from the Netherlands Cancer Registry. Data were retrieved from individual patient files and pathology reports. pCD-rates were compared using Chi-square tests and OS was estimated by Kaplan-Meier analyses. Multivariable analyses were conducted to determine odds (OR) and hazard ratios (HR) for pCD-status and OS, respectively. We included 4,504 (82%) patients with cT2 and 1,013 (18%) with cT3-4a UC. Median follow-up was 9.2 years. In cT2 UC, pCD-rate was 25% after upfront RC versus 43% (p < 0.001) and 33% (p = 0.130) after NAC + RC and NAR + RC, respectively. In cT3-4a UC, pCD-rate was 8% after upfront RC versus 37% (p < 0.001) and 16% (p = 0.281) after NAC + RC and NAR + RC, respectively. In cT2 UC, 5-year OS was 57% and 51% for NAC + RC and upfront RC, respectively (p = 0.135), whereas in cT3-4a UC, 5-year OS was 55% for NAC + RC versus 36% for upfront RC (p < 0.001). In multivariable analysis for OS, NAC was beneficial in cT3-4a UC (HR: 0.67, 95%CI 0.51-0.89) but not in cT2 UC (HR: 0.91, 95%CI 0.72-1.15). NAR did not influence OS. In conclusion, NAC + RC was associated with superior pCD compared to RC alone and NAR + RC. Superior OS for NAC + RC compared to RC alone was especially evident in cT3-4a disease.

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Section: Discussionmentioning

confidence: 99%

Superior efficacy of neoadjuvant chemotherapy and radical cystectomy in cT3‐4aN0M0 compared to cT2N0M0 bladder cancer

Hermans

Voskuilen

Deelen

et al. 2018

Intl Journal of Cancer

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“…Eine neoadjuvante RTX kann ein Downstaging in bis zu 56 % der Fälle ermöglichen [48]. Hieraus resultiert jedoch kein signifikanter OS-Vorteil [49].…”

Section: Neoadjuvante Strahlentherapieunclassified

Nur die Chirurgie? Multimodalkonzepte mit kurativer Intention für das Urothelkarzinom der Harnblase

2020

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ZusammenfassungDie radikale Zystektomie ist der Goldstandard zur Behandlung des muskelinvasiven Urothelkarzinoms. Insbesondere bei Patienten mit fortgeschrittenen Tumoren spielen multimodale, neoadjuvante oder adjuvante Therapiekonzepte eine zunehmend wichtige Rolle für die optimale Patientenversorgung. Zudem sind bei älteren und komorbideren Patienten, die unfit für eine radikale Zystektomie sind, alternative Therapiekonzepte erforderlich. Dieser Artikel fasst die aktuelle Literatur multimodaler Therapien im neoadjuvanten und adjuvanten Setting zusammen und beleuchtet Alternativen zur radikalen Zystektomie mit kurativem Therapieansatz. Ebenfalls werden erste Erkenntnisse über den Einsatz neuer, vielversprechender Therapieoptionen wie der Immuncheckpoint-Blockade im multimodalen Therapieansatz zusammengefasst.

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“…Adjuvant chemotherapy (AC) after RC can be used for high-risk M0 patients, such as those with pT3/4 and/or lymph node-positive (N+) disease [16]. A retrospective study from 2009 compared the long-term outcome of preoperative versus no preoperative radiation therapy (RT) in clinical T1-3 tumors [17]. The study showed that preoperative RT could lead to a reduction in order to prolong progression-free survival (PFS) [17].…”

Section: Treatment For Bladder Cancermentioning

confidence: 99%

“…A retrospective study from 2009 compared the long-term outcome of preoperative versus no preoperative radiation therapy (RT) in clinical T1-3 tumors [17]. The study showed that preoperative RT could lead to a reduction in order to prolong progression-free survival (PFS) [17]. External beam radiation therapy (EBRT) may be given preoperatively (neoadjuvant), postoperatively (adjuvant), or as radical treatment for patients with muscle-infiltrating cancer with no proven metastases to lymph nodes or distant metastases [6].…”

Section: Treatment For Bladder Cancermentioning

confidence: 99%

Development of Non-Invasive Biosensor Devices for the Detection of Bladder Cancer in Urine

Park¹,

Kim²,

Jung³

2020

COR

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Bladder cancer (BC) is the fourth most common malignant tumor in the United States. It is the second most common cancer of the urinary system, accounting for 7% of all new cancer cases. It is also the fifth deadliest cancer, accounting for 4% of all cancer-related deaths in the United States. Our efforts to reduce costs of BC diagnosis and improve patients’ quality of life by avoiding unnecessary invasive diagnostic tests resulted in findings of promising urinary biomarkers for the detection of BC. This short review article aims to provide the current status of non-invasive biosensor device development for detection of BC, in particular, in patients’ urine samples.

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Downstaging and survival benefits of neoadjuvant radiotherapy before cystectomy for patients with invasive bladder carcinoma

Abstract: In this retrospective study neoadjuvant radiotherapy before the cystectomy resulted in significant downstaging of invasive bladder transitional cell carcinoma. This downstaging was most significant for patients with cT3 tumours leading to prolonged survival.

Cited by 19 publications

References 21 publications

Superior efficacy of neoadjuvant chemotherapy and radical cystectomy in cT3‐4aN0M0 compared to cT2N0M0 bladder cancer

Superior efficacy of neoadjuvant chemotherapy and radical cystectomy in cT3‐4aN0M0 compared to cT2N0M0 bladder cancer

Nur die Chirurgie? Multimodalkonzepte mit kurativer Intention für das Urothelkarzinom der Harnblase

Development of Non-Invasive Biosensor Devices for the Detection of Bladder Cancer in Urine

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