- In men with muscle-invasive bladder cancer (MIBC), neoadjuvant chemotherapy (NACT) was associated with superior DFS vs adjuvant chemotherapy (ACT), but not OS or cancer-specific survival (CSS).
- After NACT, patients with complete pathologic response (pT0) vs residual disease (≥pT1) showed higher DFS and OS
Why this matters
- Limited evidence comparing NACT and ACT is available.
- Study of 656 patients with MIBC (>pT2) from RISC (Retrospective International Study of Cancers of the Urothelial Tract) database who underwent cystectomy during 2005-2012.
- 325 patients were treated with ACT and 331 with NACT.
- Funding: None disclosed.
- In the NACT vs ACT group, 74.9% vs 71.1% of patients received cisplatin-based chemotherapy.
- Median DFS was significantly longer in patients who received NACT vs ACT (34.6 vs 24.9 months; HR, 0.78; P=.02).
- No difference was observed between NACT and ACT in
- CSS (115.2 vs 92.8 months; HR, 1.06; P=.70) and
- OS (51.7 vs 66.8 months; HR, 1.08; P=.57).
- In the NACT group, patients with pT0 vs ≥pT1 disease showed higher
- 5-year DFS: 62% vs 21% (P<.0001 and>
- 5-year OS: 72% vs 31% (P<.0001>
- Retrospective design.