Does the diagnosis of 'Carcinoma in situ' at the time on initial TURBT have an impact on oncological response in patients treated with Neoadjuvant chemotherapy followed by Radical Cystectomy? - Results of an International consortium
Author(s):
Mr Nikhil Vasdev
,
Mr Nikhil Vasdev
Affiliations:
Dr Homi Zagar
,
Dr Homi Zagar
Affiliations:
Mr Jonathan Noel
,
Mr Jonathan Noel
Affiliations:
Mr Rajan Veeratterapillay
,
Mr Rajan Veeratterapillay
Affiliations:
Mr Andrew Thorpe
,
Mr Andrew Thorpe
Affiliations:
Dr Peter Black
Dr Peter Black
Affiliations:
BAUS ePoster online library. Noel J. 06/26/17; 177341; P1-14
Mr. Jonathan Noel
Mr. Jonathan Noel
Login now to access Regular content available to all registered users.

You may also access this content "anytime, anywhere" with the Free MULTILEARNING App for iOS and Android
Abstract
Discussion Forum (0)
Rate & Comment (0)
Background & Objective: Neoadjuvant chemotherapy (NAC) for muscle invasive urothelial bladder cancer (MIBC) has been shown to improve all cause and cancer specific mortality.To our knowledge, there is no data on the impact of concomitant carcinoma in situ (CIS) on outcomes of these patients.

Methodology: From 2000 – 2013, data on patients with MIBC who underwent NAC was retrospectively collected from 19 centers across the UK, Europe, Canada and USA, including 1397 patients with cT2–T4a bladder cancer (20.5% with concomitant CIS,79.5% without CIS).

Results: Baseline characteristics of the CIS versus no CIS patients were similar with median age (65 & 65), gender distribution (75.3% & 76.1% Male) and smoking status (24.4% and 25.5% never smoked), respectively. Urothelial histology with or without differentiation comprised the majority of primary TURBT histopathology; only 0.3% and 0.6% had squamous or adenocarcinoma histology, respectively. Standard cisplatin based(MVAC, ddMVAC, or GC) chemotherapy regimens were given in 77.4% of the CIS and 80.6% of the no CIS patients. Median time from TURBT to NAC and TURBT to cystectomy was 5 and 22 weeks,respectively.

Following cystectomy, the pathological outcome of the two arms: CIS and no CIS showed no significant difference in the pT0N0 (15.3% vs 22.8%) and ≤pT N0 (33.8% vs 35.8%) histopathology, respectively: From the median amount of 18 lymph nodes removed from each group: none were positive for disease.

Conclusion: In this cohort, NAC confers a favorable pathologic response rate in MIBC patients regardless of CIS status. This study is limited by its retrospective nature and lack of concordance with respect to NAC regimens.
Background & Objective: Neoadjuvant chemotherapy (NAC) for muscle invasive urothelial bladder cancer (MIBC) has been shown to improve all cause and cancer specific mortality.To our knowledge, there is no data on the impact of concomitant carcinoma in situ (CIS) on outcomes of these patients.

Methodology: From 2000 – 2013, data on patients with MIBC who underwent NAC was retrospectively collected from 19 centers across the UK, Europe, Canada and USA, including 1397 patients with cT2–T4a bladder cancer (20.5% with concomitant CIS,79.5% without CIS).

Results: Baseline characteristics of the CIS versus no CIS patients were similar with median age (65 & 65), gender distribution (75.3% & 76.1% Male) and smoking status (24.4% and 25.5% never smoked), respectively. Urothelial histology with or without differentiation comprised the majority of primary TURBT histopathology; only 0.3% and 0.6% had squamous or adenocarcinoma histology, respectively. Standard cisplatin based(MVAC, ddMVAC, or GC) chemotherapy regimens were given in 77.4% of the CIS and 80.6% of the no CIS patients. Median time from TURBT to NAC and TURBT to cystectomy was 5 and 22 weeks,respectively.

Following cystectomy, the pathological outcome of the two arms: CIS and no CIS showed no significant difference in the pT0N0 (15.3% vs 22.8%) and ≤pT N0 (33.8% vs 35.8%) histopathology, respectively: From the median amount of 18 lymph nodes removed from each group: none were positive for disease.

Conclusion: In this cohort, NAC confers a favorable pathologic response rate in MIBC patients regardless of CIS status. This study is limited by its retrospective nature and lack of concordance with respect to NAC regimens.
Code of conduct/disclaimer available in General Terms & Conditions

By clicking “Accept Terms & all Cookies” or by continuing to browse, you agree to the storing of third-party cookies on your device to enhance your user experience and agree to the user terms and conditions of this learning management system (LMS).

Cookie Settings
Accept Terms & all Cookies