METHODS: A total of 114 patients treated with systemic chemotherapy for Stage T2-T4N0-N2M0 urothelial cell carcinoma of the bladder were included in the present study. The survival times were estimated and compared using the Kaplan-Meier method and log-rank test, respectively. Univariate and multivariate Cox proportional hazards models were used to determine the statistical significance.
RESULTS: Of the 114 patients included in the present study, 37 (32%) were treated with GC and 77 (68%) with MVAC. In the neoadjuvant group, no difference was found between the 2 chemotherapeutic regimens in terms of the pathologic complete response rate at either cystectomy or during cystoscopy (14 [31%] of 45 MVAC patients vs 4 [25%] of 16 GC patients; P = .645). On multivariate analysis, the choice of regimen was not an independent predictor of cancer-specific death (hazard ratio 1.3, 95% confidence interval 0.67-2.57; P = .421) or overall survival (hazard ratio 1.3, 95% confidence interval 0.76-2.24; P = .330).
CONCLUSION: Despite the lack of data on the relative efficacy of GC versus MVAC in the neoadjuvant and adjuvant settings, these regimens have been used interchangeably. The present investigation did not find the choice of cisplatin-based regimen to be an independent predictor of survival. A trend was seen toward improved survival and a greater complete response rate in the MVAC group.
Written by:
Yeshchina O, Badalato GM, Wosnitzer MS, Hruby G, Roychoudhury A, Benson MC, Petrylak DP, McKiernan JM. Are you the author?
Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York.
Reference: Urology. 2011 Dec 21. Epub ahead of print.
doi: 10.1016/j.urology.2011.10.050
PubMed Abstract
PMID: 22196406
UroToday.com Bladder Cancer Section
