Abstract
Aim: In this study, we aimed to investigate the factors that may have the potential to predict pathological complete response (pCR) with platinum-based neoadjuvant chemotherapy (NAC) in non-metastatic muscle-invasive bladder cancer (MIBC).
Methods: Our study included 46 patients diagnosed with non-metastatic MIBC, who applied to Dicle University Medical Oncology Clinic between 2016-2019 years and received NAC. Age, gender, ECOG performance score, tumor grade, pathological tumor (pT) stage, clinical lymph node (cN) status, localization of the primary tumor in the bladder, presence of comorbid diseases, renal failure status, hydronephrosis, and NAC regimens were analyzed.
Results: Of the total 46 patients included in the study, 42 (81.3%) were male and 4 (8.7%) were female. The median age at diagnosis was 61.5 (34-77) years. In the group of patients aged <65 years, pCR was achieved in 9 patients (33.3%) and pCR was not achieved in 18 patients. The rate of pCR after NAC in the patient group aged <65 years was higher than in the age ≥65 group, which was statistically significant (p: 0.03). While the median disease-free survival (DFS) was not reached in the pCR arm, the median DFS was calculated as 26 months (95% CI: 4.6-47.3) in the non-pCR arm (Log Rank p=0.23). The mean overall survival (OS) value in the pCR arm was 126 months (95% CI: 106.5-145.4) and the mean OS value in the non-pCR arm was 53.5 months (95% CI: 44.2-62.9) (Log Rank p=0.05).
Conclusion: In our study, age <65 years was found to be an independent prognostic factor for pCR in the neoadjuvant treatment of non-metastatic MIBC. Mean OS was better in patients who achieved pCR.
Keywords: Bladder cancer, neoadjuvant chemotherapy, pathological complete response
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Copyright © 2023 The Author(s). This is an open-access article published by Bolu İzzet Baysal Training and Research Hospital under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.
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