MP34-15 A EUROPEAN MULTI-CENTRE REPORT ON CURRENT NEOADJUVANT CHEMOTHERAPY ADMINISTRATION RATES IN ROBOT-ASSISTED RADICAL CYSTECTOMY PATIENTS AND THE IMPACT ON PATHOLOGICAL STAGING
2017-04-01

You have accessJournal of UrologyBladder Cancer: Invasive II1 Apr 2017MP34-15 A EUROPEAN MULTI-CENTRE REPORT ON CURRENT NEOADJUVANT CHEMOTHERAPY ADMINISTRATION RATES IN ROBOT-ASSISTED RADICAL CYSTECTOMY PATIENTS AND THE IMPACT ON PATHOLOGICAL STAGING Justin Collins, Abolfazl Hosseini, Christofer Adding, Anthony Koupparis, Edward Rowe, Matthew Perry, Rami Issa, Tommy Nyberg, Martin Schumacher, Carl Wijburg, A. Erdem Canda, Mevlana Balbay, Karel Decaestecker, Christian Schwentner, Arnulf Stenzl, Sebastian Edeling, Sasa Pokupik, Ferderiek D'Hondt, Alexandre Mottrie, and Peter Wiklund Justin CollinsJustin Collins More articles by this author , Abolfazl HosseiniAbolfazl Hosseini More articles by this author , Christofer AddingChristofer Adding More articles by this author , Anthony KoupparisAnthony Koupparis More articles by this author , Edward RoweEdward Rowe More articles by this author , Matthew PerryMatthew Perry More articles by this author , Rami IssaRami Issa More articles by this author , Tommy NybergTommy Nyberg More articles by this author , Martin SchumacherMartin Schumacher More articles by this author , Carl WijburgCarl Wijburg More articles by this author , A. Erdem CandaA. Erdem Canda More articles by this author , Mevlana BalbayMevlana Balbay More articles by this author , Karel DecaesteckerKarel Decaestecker More articles by this author , Christian SchwentnerChristian Schwentner More articles by this author , Arnulf StenzlArnulf Stenzl More articles by this author , Sebastian EdelingSebastian Edeling More articles by this author , Sasa PokupikSasa Pokupik More articles by this author , Ferderiek D'HondtFerderiek D'Hondt More articles by this author , Alexandre MottrieAlexandre Mottrie More articles by this author , and Peter WiklundPeter Wiklund More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1032AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Neoadjuvant chemotherapy is considered the standard of care in patients with muscle-invasive bladder cancer (MIBC) and has been shown to confer overall survival advantages of 5% in RCTs. Data on neoadjuvant chemotherapy (NAC) administration rates in patients undergoing robot-assisted radical cystectomy (RARC) is limited, ranging from 0 to 31% in the published literature. We report administration rates of NAC from a multi-institutional European database focusing on the centres performing totally intracorporeal RARC. Reporting the effect of NAC on down-staging and up-staging rates from clinical staging (cT) to the pathological specimen (pT). METHODS Retrospective review of the prospectively populated multi-institutional database identified 717 patients at 9 different Institutions (6 countries), with a minimum of 12 months follow-up, who underwent RARC for non-metastatic bladder cancer with curative intent between Dec 2003 and March 2015. Clinical stage was assigned based on a combination of specimen pathology from TURBT, EUA and imaging studies. Cisplatin based NAC was offered to patients with cT2-cT4, taking into account patient performance status. Clinical staging, pathologic staging and survival data at the latest follow-up were collected. RESULTS Median age was 68 years, 78% were men. 95.2% of patients had TCC. 532 (74.2%) patients were alive at the time of the analysis. The median follow-up time for patients was 31 months (IQR 20-46). 465 patients (65%) had cT2-T4 TCC. In this series 25.3% of patients received NAC. See table 1 for upstaging and down-staging related to NAC. PSM rates were associated with upstaging (p<0.001). On multivariable analysis NAC was associated with down-staging in all patients OR 3.46 95% CI 2.34-5.13 p <0.001 and this effect increased in patients with non-organ confined disease OR 5.45 95%CI 2.15-13.8 p<0.001. The 5-year CSS, OS and RFS were 69.9%, 66.1% and 66.3% respectively. On multivariable analysis, pathological non-organ confined versus organ confined disease was found to impact CSS, OS and RFS (HR 4.4, 3.8 and 3.8 respectively). CONCLUSIONS NAC was associated with downstaging of MIBC. Increasing NAC administration rates would likely further improve oncological outcomes. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e432-e433 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Justin Collins More articles by this author Abolfazl Hosseini More articles by this author Christofer Adding More articles by this author Anthony Koupparis More articles by this author Edward Rowe More articles by this author Matthew Perry More articles by this author Rami Issa More articles by this author Tommy Nyberg More articles by this author Martin Schumacher More articles by this author Carl Wijburg More articles by this author A. Erdem Canda More articles by this author Mevlana Balbay More articles by this author Karel Decaestecker More articles by this author Christian Schwentner More articles by this author Arnulf Stenzl More articles by this author Sebastian Edeling More articles by this author Sasa Pokupik More articles by this author Ferderiek D'Hondt More articles by this author Alexandre Mottrie More articles by this author Peter Wiklund More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...