Outcome of patients with clinically node-positive bladder cancer undergoing consolidative surgery after preoperative chemotherapy

The M.D. Anderson Cancer Center Experience

Philip L. Ho, Daniel L. Willis, Jeevitha Patil, Lianchun Xiao, Stephen Williams, Jonathan J. Melquist, Karen Tart, Sahil Parikh, Jay B. Shah, Scott E. Delacroix, Neema Navai, Arlene Siefker-Radtke, Colin P. Dinney, Louis L. Pisters, Ashish M. Kamat

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Purpose Patients with urothelial cancer with nodal metastasis have a poor prognosis, with many deemed incurable. We report outcomes of a prospective clinical protocol of patients with clinically node-positive disease treated via a multimodality treatment approach. Patients and methods A total of 55 patients with bladder urothelial carcinoma with concurrent node-positive disease including pelvic nodal and retroperitoneal lymph node (RPLN) involvement underwent preoperative chemotherapy followed by consolidative surgery between 1995 and 2010. Associations between clinicopathologic factors and outcomes were analyzed using log-rank test and Cox regression analysis. Results Median cancer-specific survival (CSS) was 26 months (95% CI: 12.9–not applicable) for all patients. A total of 30 (55%) patients had pN0 category disease at the time of surgical extirpation. Despite radiologic complete response after chemotherapy, 6 of 21 patients (29%) had pN+category disease. The 5-year CSS rate was 66% for pN0 category disease vs. 12% for pN+category disease (P

Original languageEnglish (US)
Pages (from-to)59.e1-59.e8
JournalUrologic Oncology: Seminars and Original Investigations
Volume34
Issue number2
DOIs
StatePublished - Feb 1 2016
Externally publishedYes

Fingerprint

Urinary Bladder Neoplasms
Drug Therapy
Neoplasms
Clinical Protocols
Urinary Bladder
Survival Rate
Lymph Nodes
Regression Analysis
Neoplasm Metastasis
Carcinoma
Survival

Keywords

  • Bladder cancer
  • Multimodality treatment approach
  • Node-positive disease
  • Preoperative chemotherapy
  • Surgical consolidation

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Outcome of patients with clinically node-positive bladder cancer undergoing consolidative surgery after preoperative chemotherapy : The M.D. Anderson Cancer Center Experience. / Ho, Philip L.; Willis, Daniel L.; Patil, Jeevitha; Xiao, Lianchun; Williams, Stephen; Melquist, Jonathan J.; Tart, Karen; Parikh, Sahil; Shah, Jay B.; Delacroix, Scott E.; Navai, Neema; Siefker-Radtke, Arlene; Dinney, Colin P.; Pisters, Louis L.; Kamat, Ashish M.

In: Urologic Oncology: Seminars and Original Investigations, Vol. 34, No. 2, 01.02.2016, p. 59.e1-59.e8.

Research output: Contribution to journalArticle

Ho, PL, Willis, DL, Patil, J, Xiao, L, Williams, S, Melquist, JJ, Tart, K, Parikh, S, Shah, JB, Delacroix, SE, Navai, N, Siefker-Radtke, A, Dinney, CP, Pisters, LL & Kamat, AM 2016, 'Outcome of patients with clinically node-positive bladder cancer undergoing consolidative surgery after preoperative chemotherapy: The M.D. Anderson Cancer Center Experience', Urologic Oncology: Seminars and Original Investigations, vol. 34, no. 2, pp. 59.e1-59.e8. https://doi.org/10.1016/j.urolonc.2015.08.012
Ho, Philip L. ; Willis, Daniel L. ; Patil, Jeevitha ; Xiao, Lianchun ; Williams, Stephen ; Melquist, Jonathan J. ; Tart, Karen ; Parikh, Sahil ; Shah, Jay B. ; Delacroix, Scott E. ; Navai, Neema ; Siefker-Radtke, Arlene ; Dinney, Colin P. ; Pisters, Louis L. ; Kamat, Ashish M. / Outcome of patients with clinically node-positive bladder cancer undergoing consolidative surgery after preoperative chemotherapy : The M.D. Anderson Cancer Center Experience. In: Urologic Oncology: Seminars and Original Investigations. 2016 ; Vol. 34, No. 2. pp. 59.e1-59.e8.
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AB - Purpose Patients with urothelial cancer with nodal metastasis have a poor prognosis, with many deemed incurable. We report outcomes of a prospective clinical protocol of patients with clinically node-positive disease treated via a multimodality treatment approach. Patients and methods A total of 55 patients with bladder urothelial carcinoma with concurrent node-positive disease including pelvic nodal and retroperitoneal lymph node (RPLN) involvement underwent preoperative chemotherapy followed by consolidative surgery between 1995 and 2010. Associations between clinicopathologic factors and outcomes were analyzed using log-rank test and Cox regression analysis. Results Median cancer-specific survival (CSS) was 26 months (95% CI: 12.9–not applicable) for all patients. A total of 30 (55%) patients had pN0 category disease at the time of surgical extirpation. Despite radiologic complete response after chemotherapy, 6 of 21 patients (29%) had pN+category disease. The 5-year CSS rate was 66% for pN0 category disease vs. 12% for pN+category disease (P

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