- In patients with cT2N0 bladder cancer and no preoperative hydronephrosis undergoing radical cystectomy, neoadjuvant chemotherapy (NAC) improves the rate of pathologic complete response and downstaging.
Why this matters
- NAC is underused in stage T2 disease.
- Study findings reinforce the current recommendations regarding NAC in cT2-T4a muscle invasive bladder cancer.
- 619 patients with cT2N0 bladder cancer with no preoperative hydronephrosis underwent radical cystectomy with or without neoadjuvant chemotherapy.
- Funding: None disclosed.
- In patients who received NAC vs those who underwent upfront surgery:
- Complete response rate was 30% vs 3%.
- Objective response rate was 55% vs 24%.
- NAC was an independent predictor of:
- Objective response rate (OR, 2.82; P=.004).
- Complete response (OR, 4.91; P=.001).
- No significant difference in OS was observed between groups (OR, 0.78; P=.3) with a median follow-up of 18 months.
- Short follow-up and low number of events.