Show simple item record

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.identifier.citationWorld J Urol. 2022 Nov;40(11):2707-2715. doi: 10.1007/s00345-022-04160-7. Epub 2022 Sep 28.
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.rights© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
dc.subject*Urinary Bladder Neoplasms/drug therapy/surgery
dc.subjectNeoadjuvant Therapy/methods
dc.subjectCisplatin/therapeutic use
dc.subjectAntineoplastic Combined Chemotherapy Protocols/therapeutic use
dc.subjectRetrospective sudies
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.

Files in this item


There are no files associated with this item.

This item appears in the following Collection(s)

Show simple item record