Cisplatin eligibility in the neoadjuvant setting of patients with muscle-invasive bladder cancer undergoing radical cystectomy

被引:2
作者
Pichler, Renate [1 ]
Fritz, Josef [2 ]
Mari, Andrea [3 ]
Cadenar, Anna [3 ]
von Deimling, Markus [4 ]
Marcq, Gautier [5 ]
del Giudice, Francesco [6 ]
Leonardo, Costantino [6 ]
Bologna, Eugenio [6 ]
Mori, Keiichiro [7 ]
Tahbaz, Rana [8 ]
De Santis, Maria [8 ,9 ]
Klatte, Tobias [8 ]
Erber, Barbara [8 ]
Lackner, Felizian [1 ]
Kronbichler, Andreas [10 ,11 ]
Seeber, Andreas [12 ]
Fisch, Margit [4 ]
Moschini, Marco [13 ]
Pradere, Benjamin [14 ]
Mertens, Laura S. [15 ]
机构
[1] Med Univ Innsbruck, Comprehens Canc Ctr Innsbruck CCCI, Dept Urol, Anichstr 35, A-6020 Innsbruck, Austria
[2] Med Univ Innsbruck, Inst Med Stat & Informat, A-6020 Innsbruck, Austria
[3] Univ Florence, Careggi Hosp, Dept Expt & Clin Med, Unit Oncol Minimally Invas Urol & Androl, Florence, Italy
[4] Univ Med Ctr Hamburg Eppendorf, Dept Urol, D-20249 Hamburg, Germany
[5] CHU Lille, Claude Huriez Hosp, Dept Urol, F-59037 Lille, France
[6] Sapienza Univ Rome, Policlin Umberto Hosp 1, Dept Maternal Infant & Urol Sci, I-00161 Rome, Italy
[7] Jikei Univ, Sch Med, Dept Urol, Tokyo 1058461, Japan
[8] Charite Univ Med Berlin, Dept Urol, D-10117 Berlin, Germany
[9] Med Univ Vienna, Dept Urol, A-1090 Vienna, Austria
[10] Univ Cambridge, Dept Med, Cambridge CB2 0QQ, England
[11] Med Univ Innsbruck, Dept Internal Med 4, A-6020 Innsbruck, Austria
[12] Med Univ Innsbruck, Comprehens Canc Ctr Innsbruck, Dept Hematol & Oncol, A-6020 Innsbruck, Austria
[13] Salute San Raffaele Univ, IRCCS Osped San Raffaele Vita, Dept Urol, I-20132 Milan, Italy
[14] La Croix Sud Hosp, Dept Urol, F-31130 Quint Fonsegrives, France
[15] Antoni Leeuwenhoek Hosp, Netherlands Canc Inst, Dept Urol, NL-1006 Amsterdam, Netherlands
关键词
muscle-invasive bladder cancer; radical cystectomy; neoadjuvant chemotherapy; cisplatin eligibility; kidney function; creatinine clearance; METASTATIC UROTHELIAL CARCINOMA; MEASURED CREATININE CLEARANCE; CHEMOTHERAPY; GEMCITABINE; EQUATION; UNFIT;
D O I
10.1093/oncolo/oyae160
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background To examine the agreement of different calculated estimated glomerular filtration rate (eGFR) formulas and measured creatinine clearance (CrCI) at the primary diagnosis of muscle-invasive bladder cancer (MIBC). Materials and Methods We performed a multicenter analysis of patients with MIBC, treated with cisplatin-based neoadjuvant chemotherapy (NAC) and radical cystectomy (RC), or with RC alone, between 2011 and 2021. Baseline eGFR was computed using 4 calculated serum equations including Cockcroft-Gault (CG), MDRD, CKD-EPI 2009, and race-free CKD-EPI 2021. To examine the association between calculated eGFR and measured CrCI, subgroup analyses were performed among patients in whom measured 24-hour urine CrCl was determined. Cisplatin-ineligibility was defined as CrCI and/or eGFR < 60 mL/minute per 1.73 m2. Results Of 956 patients, 30.0%, 33.3%, 31.9%, and 27.7% were found to be cisplatin-ineligible by the CG, MDRD, CKD-EPI, and race-free CKD-EPI equations (P = .052). The concordance between calculated eGFR formulas was rated substantial (Cohen's kappa (k): 0.66-0.95). Among the subgroup (n = 245) with measured CrCl, 37 (15.1%) patients had a CrCI less than 60 mL/minute. Concordance between measured CrCl and calculated eGFR was poor (& kgreen;: 0.29-0.40). All calculated eGFR formulas markedly underestimated the measured CrCI. Specifically, 78%-87.5% of patients with a calculated eGFR between 40 and 59 mL/minute exhibited a measured CrCI >= 60 mL/minute. Conclusions Comparing calculated eGFR formulas, similar percentages of patients with MIBC were deemed cisplatin-ineligible. However, a significant number of patients could be upgraded by being cisplatin-fit based on measured CrCI, particularly when the calculated eGFR was falling within the gray range of 40-59 mL/minute.
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收藏
页码:e1511 / e1522
页数:12
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