Perioperative Chemotherapy for Bladder Cancer Survival
(HealthDay News) — The use of neoadjuvant and adjuvant chemotherapy for the treatment of muscle-invasive bladder cancer (MIBC) is associated with a survival benefit in the general population, and may be underutilized, according to research published online April 14 in Cancer.
Christopher M. Booth, MD, of Queen's University in Kingston, Canada, and colleagues analyzed data from medical records and a population-based registry for 2,044 patients who underwent cystectomy for MIBC from 1994–2008. The authors sought to assess the effects of perioperative chemotherapy.
The researchers found that the use of neoadjuvant chemotherapy remained stable during the study period (mean, 4%), while use of adjuvant chemotherapy increased over time from 16 to 22 percent. Adjuvant chemotherapy was more likely to be used in patients with stage T3/T4 disease (odds ratio [OR], 1.83; 95% confidence interval [CI], 1.38–2.46) and node-positive disease (OR, 8.10; 95% CI, 6.20–10.70). Use of adjuvant chemotherapy in patients with MIBC was associated with reduced risks of five-year overall mortality (hazard ratio [HR], 0.71; 95% CI, 0.62–0.81) and cancer-specific mortality (HR, 0.73; 95% CI, 0.64–0.84).
"In summary, our study demonstrates low utilization of perioperative chemotherapy for bladder cancer in the general population," the authors write. "Our results suggest that adjuvant chemotherapy is associated with a substantial survival benefit in the general population."