Abstract
Objective
The efficacy of chemotherapy on UCSD is not known. This study was conducted to investigate
the efficacy of cisplatin-based chemotherapy and prognosis of patients with UC with
or without SD of the bladder.
Methods
Patients with invasive bladder cancer (clinical T3-4aN0M0) who were treated between
March 2003 and March 2015 with 2 or 3 cycles of neoadjuvant chemotherapy followed
by radical cystectomy were retrospectively evaluated. Treatment outcomes were compared
for each pathologic type in UCSD and pure UC. The primary end point was pathologic
response in the cystectomy specimens. Disease-free survival and overall survival were
secondary end points.
Results
We evaluated 9 patients with UCSD and 29 patients with pure UC. In the cystectomy
specimens, pathologic complete response without residual tumors was not seen in any
patients with UCSD, but evident in 10 patients (34.5%) with pure UC. The proportion
of pathologic downstaging was significantly lower in patients with UCSD than in those
with pure UC (11.1% vs. 51.7%; P = .031). Patients with UCSD had poorer disease-free survival (P < .001) and overall survival (P = .001) than those with pure UC. On multivariate Cox regression analysis, SD in UC
was an independent predictor of recurrence (hazard ratio, 4.43; 95% confidence interval,
1.44-13.6, P = .009) and mortality (hazard ratio, 3.51; 95% confidence interval, 1.11-11.1, P = .032).
Conclusions
UCSD of the bladder is less sensitive to cisplatin-based chemotherapy and has poor
prognosis.
Keywords
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Article info
Publication history
Published online: July 21, 2017
Accepted:
July 18,
2017
Received in revised form:
July 13,
2017
Received:
April 29,
2017
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
