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dc.contributor.authorEinerhand, S. M. H.
dc.contributor.authorBlack, A. J.
dc.contributor.authorZargar, H.
dc.contributor.authorFairey, A. S.
dc.contributor.authorDinney, C. P.
dc.contributor.authorMir, M. C.
dc.contributor.authorKrabbe, L. M.
dc.contributor.authorCookson, M. S.
dc.contributor.authorJacobson, N. E.
dc.contributor.authorMontgomery, J. S.
dc.contributor.authorVasdev, N.
dc.contributor.authorYu, E. Y.
dc.contributor.authorXylinas, E.
dc.contributor.authorKassouf, W.
dc.contributor.authorDall'Era, M. A.
dc.contributor.authorSridhar, S. S.
dc.contributor.authorMcGrath, J. S.
dc.contributor.authorAning, J.
dc.contributor.authorShariat, S. F.
dc.contributor.authorWright, J. L.
dc.contributor.authorThorpe, A. C.
dc.contributor.authorMorgan, T. M.
dc.contributor.authorHolzbeierlein, J. M.
dc.contributor.authorBivalacqua, T. J.
dc.contributor.authorNorth, S.
dc.contributor.authorBarocas, D. A.
dc.contributor.authorLotan, Y.
dc.contributor.authorGrivas, P.
dc.contributor.authorGarcia, J. A.
dc.contributor.authorStephenson, A. J.
dc.contributor.authorShah, J. B.
dc.contributor.authorDaneshmand, S.
dc.contributor.authorZargar-Shoshtari, K.
dc.contributor.authorSpiess, P. E.
dc.contributor.authorvan Rhijn, B. W. G.
dc.contributor.authorBlack, P. C.
dc.contributor.authorMertens, L. S.
dc.date.accessioned2023-01-12T14:26:34Z
dc.date.available2023-01-12T14:26:34Z
dc.date.issued2022-11-01
dc.identifier.citationWorld J Urol. 2022 Nov;40(11):2707-2715. doi: 10.1007/s00345-022-04160-7. Epub 2022 Sep 28.
dc.identifier.pmid36169695
dc.identifier.doi10.1007/s00345-022-04160-7
dc.identifier.urihttps://rde.dspace-express.com/handle/11287/622772
dc.description.abstractPURPOSE: Cisplatin-based chemotherapy followed by radical cystectomy (RC) is recommended in patients with muscle-invasive bladder cancer (MIBC). However, up to 50% of patients are cisplatin ineligible. The aim of this study was to compare clinical outcomes after ≥ 3 cycles of preoperative gemcitabine-carboplatin (gem-carbo) versus gemcitabine-cisplatin (gem-cis). METHODS: We identified 1865 patients treated at 19 centers between 2000 and 2013. Patients were included if they had received ≥ 3 cycles of neoadjuvant (cT2-4aN0M0) or induction (cTanyN + M0) gem-carbo or gem-cis followed by RC. RESULTS: We included 747 patients treated with gem-carbo (n = 147) or gem-cis (n = 600). Patients treated with gem-carbo had a higher Charlson Comorbidity Index (p = 0.016) and more clinically node-positive disease (32% versus 20%; p = 0.013). The complete pathological response (pCR; ypT0N0) rate did not significantly differ between gem-carbo and gem-cis (20.7% versus 22.1%; p = 0.73). Chemotherapeutic regimen was not significantly associated with pCR (OR 0.99 [95%CI 0.61-1.59]; p = 0.96), overall survival (OS) (HR 1.20 [95%CI 0.85-1.67]; p = 0.31), or cancer-specific survival (CSS) (HR 1.35 [95%CI 0.93-1.96]; p = 0.11). Median OS of patients treated with gem-carbo and gem-cis was 28.6 months (95%CI 18.1-39.1) and 45.1 months (95%CI 32.7-57.6) (p = 0.18), respectively. Median CSS of patients treated with gem-carbo and gem-cis was 28.8 months (95%CI 9.8-47.8) and 71.0 months (95%CI median not reached) (p = 0.02), respectively. Subanalyses of the neoadjuvant and induction setting did not show significant survival differences. CONCLUSION: Our results show that a subset of cisplatin-ineligible patients with MIBC achieve pCR on gem-carbo and that survival outcomes seem comparable to gem-cis provided patients are able to receive ≥ 3 cycles and undergo RC.
dc.language.isoeng
dc.publisherSpringer
dc.rights© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
dc.subjectHumans
dc.subject*Cystectomy
dc.subject*Urinary Bladder Neoplasms/drug therapy/surgery
dc.subjectNeoadjuvant Therapy/methods
dc.subjectCisplatin/therapeutic use
dc.subjectCarboplatin
dc.subjectAntineoplastic Combined Chemotherapy Protocols/therapeutic use
dc.subjectMuscles
dc.subjectRetrospective sudies
dc.subjectBladder
dc.subjectChemotherapy
dc.subjectCisplatin
dc.subjectNeoadjuvant
dc.subjectRadical cystectomy
dc.subjectUrothelial cancer
dc.titleMulticenter evaluation of neoadjuvant and induction gemcitabine-carboplatin versus gemcitabine-cisplatin followed by radical cystectomy for muscle-invasive bladder cancer
dc.typeJournal Article
dc.identifier.journalWorld journal of urology
dc.description.noteRD&E staff can access the full-text of this article by clicking on the 'Additional Link' above and logging in with NHS OpenAthens if prompted.
dc.type.versionppublish
dc.description.admin-note0
dc.date.epub2022-09-29
dc.citation.volume40
dc.citation.issue11
dc.citation.spage2707-2715


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