Oncological outcomes of patients with node positive disease following neoadjuvant chemotherapy and radical cystectomy for muscle-invasive bladder cancer: A multicenter observational study of the EAU Young Academic Urologists (YAU) urothelial carcinoma working group

被引：0

作者：

Marcq, G. ^{[1
,2
,3
]}

Kassouf, W. ^{[1
]}

Roumiguie, M. ^{[4
]}

Pradere, B. ^{[5
,6
]}

Mertens, L. S. ^{[7
]}

Albisinni, S. ^{[8
,9
]}

Cimadamore, A. ^{[10
]}

Teoh, J. Yuen-Chun ^{[11
]}

Moschini, M. ^{[12
,13
]}

Laukhtina, E. ^{[6
,14
]}

Mari, A. ^{[15
]}

Soria, F. ^{[16
]}

Gallioli, A. ^{[17
]}

del Giudice, F. ^{[18
]}

d'Andrea, D. ^{[6
]}

Krajewski, W. ^{[19
]}

Beauval, J. B. ^{[5
]}

Xylinas, E. ^{[20
]}

Pouessel, D. ^{[21
]}

Sargos, P. ^{[22
]}

Ploussard, G. ^{[5
]}

机构：

[1] McGill Univ, Ctr Salud, McGill Urol Oncol Res, Montreal, PQ, Canada

[2] CHU Lille, Hosp Claude Huriez, Dept Urol, F-59000 Lille, France

[3] Univ Lille, CANTHER Heterogeneidad Plasticidad & Resistencia C, CNRS, Inst Pasteur Lille,CHU Lille,Inserm,UMR9020,U1277, Lille, France

[4] CHU Toulouse, Dept Urol, IUC, Toulouse, France

[5] Hosp La Croix Sud, Dept Urol, Quint Fonsegrives, France

[6] CeMM Res Ctr Mol Med, Viena, Austria

[7] Inst Urol, Dept Urol, Dhule, Maharashtra, India

[8] Univ Libre Bruselas, Inst Estudios Europeos, Bruselas, Belgium

[9] Univ Roma Tor Vergata, Hosp Univ Tor Vergata, Dept Biomed & Prevent, Rome, Italy

[10] Univ Politecn Marche, Secc Anat Patol, Ancona, Italy

[11] Chinese Univ Hong Kong, Dept Surg, SH Ho Urol Ctr, Hong Kong, Peoples R China

[12] IRCCS Inst Cient San Raffaele, Inst Invest Urol, Dept Urol, Milan, Italy

[13] IRCCS Inst Cient San Raffaele, Inst Invest Urol, Div Oncol Expt, Milan, Italy

[14] Sechenov Univ, Inst Urol & Salud Reprod, Moscu, Russia

[15] Univ Florence, Dept Oncol Minimally Invas Urol & Androl, Dept Med Expt & Clin, Unidad Urol Oncol & Androl Minimamente Invas, Florencia, Italy

[16] Azienda Osped Citta Salute & Sci Torino Molinette, Div Urol, AOU Ciudad Salud & Ciencia, Turin, Italy

[17] Univ Autonoma Barcelona, Fdn Puigvert, Dept Urol, Barcelona, Spain

[18] Univ Roma La Sapienza, Hosp Policlin Umberto I, Dept Ciencias Maternoinfantiles & Urol, Rome, Italy

[19] Univ Med Breslavia, Ctr Univ Excelencia Urol, Dept Urol Robot & Minimamente Invas, Breslavia, Poland

[20] Paris Diderot Univ, Univ Hosp Paris, AP HP, Dept Urol, Paris, France

[21] Inst Claudius Regaud, IUCT Inst Univ Canc Toulouse Oncopole, Dept Oncol Med, Toulouse, France

[22] Inst Bergonie, Burdeos, France

来源：

ACTAS UROLOGICAS ESPANOLAS | 2025年 / 49卷 / 02期

关键词：

Muscle-invasive bladder cancer; Neoadjuvant chemotherapy; Node-positive disease; ADJUVANT CHEMOTHERAPY; RADIATION-THERAPY;

D O I：

10.1016/j.acuro.2025.501701

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction: Until recently there was no recommended adjuvant therapy for patients with lymph nodes metastasis (ypN+) following neoadjuvant chemotherapy (NAC) and radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC). The aim of the study was to describe the oncological outcomes of ypN+ patients following NAC and RC for MIBC. Methods: This collaborative retrospective study included 195 patients with ypN+ disease after NAC followed by RC and bilateral pelvic lymph node dissection for MIBC between 2000 and 2019 in seven centers. Patients' demographics, clinical and pathological features were collected. Survival analyses were carried out with Kaplan-Meier estimates and a Cox model was generated. Results: A total of 120 patients (62%) were pN1, 51 pN2 (26%) and 24 pN3 (12%). Adjuvant radiation therapy was performed in 18 (9%), adjuvant chemotherapy in 40 (21%) and the remaining 137 (70%) patients were observed. The median follow-up time was 51 months (95% CI: 44-62). Median times for recurrence-free survival, cancer-specific survival and overall survival (OS) were 18 months (95% CI: 16-21), 47 months (95% CI: 31-70) and 28 months (95% CI: 22-34) respectively. On multivariable analysis, female gender (HR: 1.5, 95%CI: 1.002-2.21, P = .049) and positive surgical margins (HR: 1.6, 95%CI: 1.06-2.38, P = .026) were the only independent predictor of OS. The type of adjuvant therapy did not impact OS (adjuvant chemotherapy, P = .44; adjuvant radiotherapy, P = .40). Conclusion. - MIBC patients with residual node positive disease following NAC and RC have poor survival outcomes. Females and patients with positive margin status at RC carry a poorer prognosis. These results may be beneficial for clinical trial design.

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页数：9