Dados do Trabalho

Título

NEOADJUVANT CHEMOTHERAPY FOR MICROPAPILLARY UROTHELIAL VARIANT HISTOLOGY IN BLADDER CANCER: IMPACT IN SURVIVAL OUTCOMES

Introdução e Objetivo

Patients with micropapillary urothelial variant histology have a poor prognosis. It is unclear if neoadjuvant chemotherapy (NAC) prior to radical cystectomy, the standard of care for pure urothelial muscle-invasive bladder cancer (MIBC), is associated with improved overall survival for patients with MIBC with micropapillary histology. The primary objective is to assess for associations between receipt of neoadjuvant chemotherapy and overall survival for patients with micropapillary variant histology MIBC.

Método

Patients with micropapillary urothelial variant histology have a poor prognosis. It is unclear if neoadjuvant chemotherapy (NAC) prior to radical cystectomy, the standard of care for pure urothelial muscle-invasive bladder cancer (MIBC), is associated with improved overall survival for patients with MIBC with micropapillary histology. The primary objective is to assess for associations between receipt of neoadjuvant chemotherapy and overall survival for patients with micropapillary variant histology MIBC.

Resultados

680 patients underwent radical cystectomy for primary bladder cancer and 13 were included in the final study population. 7 patients received completed neoadjuvant chemotherapy with gemcitabine and cisplatin. NAC neither associated with pathologic downstaging (p=0.34; IC95%[0.34 - 1.22]) or improved overall survival for micropapillary histological variant (p = 0.530 [0.77-0.84]). 

Conclusão

In our series, we conclude that for patients with micropapillary MIBC a radical cystectomy should be preferable as a therapeutic rather than NAC followed by radical cystectomy. Neoadjuvant chemotherapy hasn't improved downstaging or overall survival for patients with a micropapillary urothelial variant.