Oncological outcomes and complications following radical cystectomy with or without neoadjuvant chemotherapy - A retrospective comparative cohort study from a single-center in South India

Neoadjuvant chemotherapy (NAC) in the management of muscle-invasive bladder carcinoma has not been adopted universally. We studied the oncological outcomes and complications in patients who underwent radical cystectomy (RC) with or without NAC. A retrospective review of patients who underwent RC wit...

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Published in:Indian journal of urology 2025-01, Vol.41 (1), p.20-27
Main Authors: Jayanth, E Selvin Theodore, Jat, Subhash L, Samuel, Benedict P, Singh, Ashish, John, Nirmal Thampi, Joel, Anjana, Mukha, Rajiv Paul, Rebecca, Grace, Mahasampath, Gowri, Berry, Chandrasingh Jeyachandra, Devasia, Antony, Kekre, Nitin, Kumar, Santosh
Format: Article
Language:English
Subjects:
Adjuvant treatment
BCG
BCG vaccines
Cancer
Chemotherapy
Complications and side effects
Medical prognosis
Patient outcomes
Prognosis
Urological surgery
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Summary:Neoadjuvant chemotherapy (NAC) in the management of muscle-invasive bladder carcinoma has not been adopted universally. We studied the oncological outcomes and complications in patients who underwent radical cystectomy (RC) with or without NAC. A retrospective review of patients who underwent RC with or without NAC from June 2009 to June 2020 was conducted. Oncological outcomes, overall survival (OS) and recurrence-free survival (RFS), complications, and prognostic factors were analyzed. Of the 314 patients who underwent RC, 83 patients received NAC (Group A), and 231 underwent RC alone (Group B). The median age was 58 years. The median follow-up duration was 22 (3-64) and 24 (3-62) months, respectively. The median OS in Group A was significantly higher than Group B (38 months [confidence interval (CI): 34-42] and 32 [CI: 29-35], respectively, [P = 0.033]). The RFS in Groups A and B was 34 (CI: 30-39) and 31 (CI: 28-34) months, respectively (P = 0.47). Higher pathological T stage (T3/4), node positivity and lymphovascular invasion (LVI) were predictors of poor OS and RFS (P < 0.0001). Clavien grades 3/4 complications were comparable (8 vs. 15; P = 0.19). Glomerular filtration rate (GFR)
ISSN:0970-1591
1998-3824
DOI:10.4103/iju.iju_214_24