UNASSIGNED: 4613 Background: ACT for IBC is controversial and supported by underpowered randomized trials. Additional information from metanalysis or longitudinal studies can help to better define its role. METHODS: Since 1988, our risk-adapted institutional policy for @entity1 (p) with IBC and radical cystectomy (C), has been to inform @entity1 about their particular risk of relapse, status of the art at that moment and @entity137 of ACT. For p with pT3-4 or N+, we recommended ACT but we offered follow-up as an alternative (C), and the opposite for pT2N0. Both cohorts, C and ACT were prospectively followed according to the standard clinical practice. We present here the results of progression-free survival (PFS), @entity1349 ( @entity1349 ) and @entity5 -specific survival (CSS) comparing C alone vs ACT. RESULTS: From 1988 to 2009, 491 p were registered, 309 C and 182 ACT (37%). Median follow-up was 68 m. ACT was MVAC x3 (90 p) CIS-GEM x4 (80 p) or Carbo-GEMx4 (12 p). There were no toxic deaths. Mean age was 65 y, and 89% were male. As expected, there was an unbalance in prognostic factors favoring C vs ACT (p < .05 for all the following comparisons): age >70y (30 vs 21%); AJCC 2010 staging (pII, pIII, pIVN+: 57,3%, 33,3%, 9,4% vs 18,1%, 33%, 48,9%); histology (papillary/solid: 41%/59% vs 21%/79%), grade (G3: 92% vs 97%), surgical complications (37 % vs 27%) and period of treatment (until 1999/2000 and later: 51%/49% vs 36%/64%). Despite this, there were no significant differences in crude PFS, @entity1349 or CSS, suggesting an effect of ACT. This effect could be demonstrated in a multivariate Cox model adjusted by the unbalanced variables. Table shows the hazard ratio (HR) of relapse and @entity204 (ACT/C). Due to interaction between stage and treatment, results are presented stratified by pathological stage. CONCLUSIONS: In our series of IBC, ACT was associated with a statistically significant reduction in the risk of relapse and @entity204 in @entity1 with extravesical extension (pIII) or N+ (pIV). [Table: see text].

Final results of a risk-adapted policy of adjuvant chemotherapy (ACT) in XXXX with invasive bladder carcinoma (IBC).

@entity1 :: ('9606', 'Species') :: ['patients'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity1349 :: ('MESH:D011475', 'Disease') :: ['OS', 'overall survival']
@entity1 :: (9606,Species) :: ['patients']
