Impact of systemic therapy on clinical T1 small-cell neuroendocrine carcinoma of the bladder

IF 7.1 2区医学 Q1 ONCOLOGY

ESMO Open Pub Date : 2024-11-01 DOI:10.1016/j.esmoop.2024.103964

A.A. Myers , A.M. Fang , M.J. Moussa , H. Hwang , N.R. Wilson , M.T. Campbell , P. Msaouel , B.H. Lee , C.C. Guo , M. Zhang , J. Zhao , A.O. Siefker-Radtke , A.M. Kamat , O. Alhalabi

{"title":"Impact of systemic therapy on clinical T1 small-cell neuroendocrine carcinoma of the bladder","authors":"A.A. Myers , A.M. Fang , M.J. Moussa , H. Hwang , N.R. Wilson , M.T. Campbell , P. Msaouel , B.H. Lee , C.C. Guo , M. Zhang , J. Zhao , A.O. Siefker-Radtke , A.M. Kamat , O. Alhalabi","doi":"10.1016/j.esmoop.2024.103964","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to analyze survival outcomes and pathologic response of patients with cT1N0 small-cell neuroendocrine carcinoma (SCNEC) of the bladder treated with neoadjuvant chemotherapy (neoCTX).</div></div><div><h3>Materials and methods</h3><div>All cases of bladder SCNEC treated at our institution from January 1996 to July 2023 were identified. cT1N0 was defined as transurethral resection pathology showing lamina propria invasion with present and uninvolved muscularis propria. Pathologic downstaging and recurrences were evaluated. Disease-free survival (DFS) and overall survival (OS) were analyzed using the Cox regression and Kaplan–Meier method.</div></div><div><h3>Results</h3><div>A total of 30 patients with cT1N0 bladder SCNEC were included. Median follow-up was 88 months [95% confidence interval (CI) 44-131 months]. NeoCTX was given to 21 (70%) patients with a median of 4 cycles (range 1-6 cycles). A total of 27 (90%) patients received definitive local therapy. In cT1 bladder SCNEC, neoCTX was associated with decreased odds of pathologic upstaging [odds ratio = 0.07 (95% CI 0.01-0.45), <em>P</em> = 0.004], decreased odds of relapse [odds ratio = 0.12 (95% CI 0.02-0.65), <em>P</em> = 0.01], improved DFS [hazard ratio (HR) 0.30, 95% CI 0.09-0.96, <em>P</em> = 0.04], and improved OS (HR 0.32, 95% CI 0.10-1.02, <em>P</em> = 0.05). Compared with cT2N0 treated with neoCTX, cT1N0 treated with neoCTX had improved median DFS (HR 0.44, 95% CI 0.19-1.03, <em>P</em> = 0.05) and improved median OS (HR 0.52, 95% CI 0.22-1.24, <em>P</em> = 0.14).</div></div><div><h3>Conclusions</h3><div>NeoCTX had suggestive benefit in patients with cT1 bladder SCNEC with decreased odds of pathologic upstaging, metastatic relapse, and improved survival.</div></div>","PeriodicalId":11877,"journal":{"name":"ESMO Open","volume":"9 11","pages":"Article 103964"},"PeriodicalIF":7.1000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ESMO Open","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2059702924017344","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

The purpose of this study was to analyze survival outcomes and pathologic response of patients with cT1N0 small-cell neuroendocrine carcinoma (SCNEC) of the bladder treated with neoadjuvant chemotherapy (neoCTX).

Materials and methods

All cases of bladder SCNEC treated at our institution from January 1996 to July 2023 were identified. cT1N0 was defined as transurethral resection pathology showing lamina propria invasion with present and uninvolved muscularis propria. Pathologic downstaging and recurrences were evaluated. Disease-free survival (DFS) and overall survival (OS) were analyzed using the Cox regression and Kaplan–Meier method.

Results

A total of 30 patients with cT1N0 bladder SCNEC were included. Median follow-up was 88 months [95% confidence interval (CI) 44-131 months]. NeoCTX was given to 21 (70%) patients with a median of 4 cycles (range 1-6 cycles). A total of 27 (90%) patients received definitive local therapy. In cT1 bladder SCNEC, neoCTX was associated with decreased odds of pathologic upstaging [odds ratio = 0.07 (95% CI 0.01-0.45), P = 0.004], decreased odds of relapse [odds ratio = 0.12 (95% CI 0.02-0.65), P = 0.01], improved DFS [hazard ratio (HR) 0.30, 95% CI 0.09-0.96, P = 0.04], and improved OS (HR 0.32, 95% CI 0.10-1.02, P = 0.05). Compared with cT2N0 treated with neoCTX, cT1N0 treated with neoCTX had improved median DFS (HR 0.44, 95% CI 0.19-1.03, P = 0.05) and improved median OS (HR 0.52, 95% CI 0.22-1.24, P = 0.14).

Conclusions

NeoCTX had suggestive benefit in patients with cT1 bladder SCNEC with decreased odds of pathologic upstaging, metastatic relapse, and improved survival.

查看原文本刊更多论文

系统治疗对临床 T1 膀胱小细胞神经内分泌癌的影响。

研究背景本研究旨在分析接受新辅助化疗（neoCTX）的cT1N0膀胱小细胞神经内分泌癌（SCNEC）患者的生存结果和病理反应：cT1N0 的定义是经尿道切除病理显示膀胱固有层受侵，且存在未受累的固有肌。对病理降期和复发进行了评估。采用 Cox 回归法和 Kaplan-Meier 法分析无病生存期（DFS）和总生存期（OS）：结果：共纳入30例cT1N0膀胱SCNEC患者。中位随访时间为88个月[95%置信区间（CI）44-131个月]。21例（70%）患者接受了NeoCTX治疗，中位数为4个周期（1-6个周期不等）。共有 27 例（90%）患者接受了明确的局部治疗。在 cT1 膀胱 SCNEC 中，neoCTX 与病理分期上升几率降低 [几率比 = 0.07 (95% CI 0.01-0.45), P = 0.004]、复发几率降低 [几率比 = 0.12 (95% CI 0.02-0.65), P = 0.01]，改善 DFS [危险比 (HR) 0.30, 95% CI 0.09-0.96, P = 0.04]，改善 OS (HR 0.32, 95% CI 0.10-1.02, P = 0.05)。与接受新CTX治疗的cT2N0相比，接受新CTX治疗的cT1N0的中位DFS有所改善（HR 0.44，95% CI 0.19-1.03，P = 0.05），中位OS有所改善（HR 0.52，95% CI 0.22-1.24，P = 0.14）：结论：NeoCTX对cT1膀胱SCNEC患者有提示性益处，可降低病理分期和转移复发的几率，并提高生存率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

ESMO Open Medicine-Oncology

CiteScore

11.70

自引率

2.70%

发文量

255

审稿时长

10 weeks

期刊介绍： ESMO Open is the online-only, open access journal of the European Society for Medical Oncology (ESMO). It is a peer-reviewed publication dedicated to sharing high-quality medical research and educational materials from various fields of oncology. The journal specifically focuses on showcasing innovative clinical and translational cancer research. ESMO Open aims to publish a wide range of research articles covering all aspects of oncology, including experimental studies, translational research, diagnostic advancements, and therapeutic approaches. The content of the journal includes original research articles, insightful reviews, thought-provoking editorials, and correspondence. Moreover, the journal warmly welcomes the submission of phase I trials and meta-analyses. It also showcases reviews from significant ESMO conferences and meetings, as well as publishes important position statements on behalf of ESMO. Overall, ESMO Open offers a platform for scientists, clinicians, and researchers in the field of oncology to share their valuable insights and contribute to advancing the understanding and treatment of cancer. The journal serves as a source of up-to-date information and fosters collaboration within the oncology community.