Clinicopathological outcomes after radical cystectomy for clinical T2 urothelial carcinoma: Further evidence to support the use of neoadjuvant chemotherapy

Daniel Canter, Christopher Long, Alexander Kutikov, Elizabeth Plimack, Ismail Saad, Megan Oblaczynski, Fang Zhu, Rosalia Viterbo, David Y.T. Chen, Robert G. Uzzo, Richard E. Greenberg, Stephen A. Boorjian

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

OBJECTIVE: To evaluate the clinicopathological outcomes for patients with clinical T2 (cT2) urothelial carcinoma treated with radical cystectomy (RC) without neoadjuvant chemotherapy (NC). PATIENTS AND METHODS We identified 212 patients with cT2 tumours who underwent RC at our institution without NC. Pathological assessment of RC specimens was correlated with clinical stage. The impact of various clinicopathological factors on the outcome of patients with cT2 disease was analysed. RESULTS In total, 153/212 (73.2%) patients with cT2 bladder cancer had either pT3/T4 or pN+ tumours at RC. Moreover, only 58/153 (37.9%) of these patients received adjuvant chemotherapy. The median follow-up was 28 (months 0.6-107.5) (range). The 5-year recurrence-free survival and cancer-specific survival (CSS) was 56.5% and 59.5%, respectively. On multivariate analysis, increasing age (hazard ratio [HR] 1.04; P= 0.04), advanced pathological stage (HR 1.83; P= 0.02), and positive lymph nodes (HR 3.72; P= 0.001) were adversely associated with CSS, while receipt of adjuvant chemotherapy was protective of disease-specific mortality (HR 0.45; P= 0.04). CONCLUSIONS Pathological upstaging is prevalent and survival remains modest in patients with cT2 tumours treated with RC without NC. Unfortunately, only 40% of patients that had locally advanced and/or regionally metastatic disease received adjuvant treatment. These data further support the value of NC for patients with muscle-invasive bladder cancer, even in those with apparent clinically organ-confined tumours.

Original languageEnglish (US)
Pages (from-to)58-62
Number of pages5
JournalBJU international
Volume107
Issue number1
DOIs
StatePublished - Jan 2011

Keywords

  • bladder cancer
  • neoadjuvant chemotherapy
  • radical cystectomy

ASJC Scopus subject areas

  • Urology

Fingerprint Dive into the research topics of 'Clinicopathological outcomes after radical cystectomy for clinical T2 urothelial carcinoma: Further evidence to support the use of neoadjuvant chemotherapy'. Together they form a unique fingerprint.

  • Cite this

    Canter, D., Long, C., Kutikov, A., Plimack, E., Saad, I., Oblaczynski, M., Zhu, F., Viterbo, R., Chen, D. Y. T., Uzzo, R. G., Greenberg, R. E., & Boorjian, S. A. (2011). Clinicopathological outcomes after radical cystectomy for clinical T2 urothelial carcinoma: Further evidence to support the use of neoadjuvant chemotherapy. BJU international, 107(1), 58-62. https://doi.org/10.1111/j.1464-410X.2010.09442.x