Resultados oncológicos de pacientes con afectación ganglionar tras quimioterapia neoadyuvante y cistectomía radical para el cáncer de vejiga músculo-invasivo: estudio observacional multicéntrico del Grupo de Trabajo de Carcinoma Urotelial de la sección de Jóvenes Urólogos Académicos de la Asociación Europea de Urología (YAU-EAU)

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas Pub Date : 2025-03-01 DOI:10.1016/j.acuro.2025.501701

G. Marcq , W. Kassouf , M. Roumiguié , B. Pradere , L.S. Mertens , S. Albisinni , A. Cimadamore , J. Yuen-Chun Teoh , M. Moschini , E. Laukhtina , A. Mari , F. Soria , A. Gallioli , F. del Giudice , D. d’Andrea , W. Krajewski , J.B. Beauval , E. Xylinas , D. Pouessel , P. Sargos , G. Ploussard

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引用次数: 0

Abstract

Introduction

Until recently there was no recommended adjuvant therapy for patients with lymph nodes metastasis (ypN+) following neoadjuvant chemotherapy (NAC) and radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC). The aim of the study was to describe the oncological outcomes of ypN+ patients following NAC and RC for MIBC.

Methods

This collaborative retrospective study included 195 patients with ypN+ disease after NAC followed by RC and bilateral pelvic lymph node dissection for MIBC between 2000 and 2019 in seven centers. Patients’ demographics, clinical and pathological features were collected. Survival analyses were carried out with Kaplan-Meier estimates and a Cox model was generated.

Results

A total of 120 patients (62%) were pN1, 51 pN2 (26%) and 24 pN3 (12%). Adjuvant radiation therapy was performed in 18 (9%), adjuvant chemotherapy in 40 (21%) and the remaining 137 (70%) patients were observed. The median follow-up time was 51 months (95% CI: 44-62). Median times for recurrence-free survival, cancer-specific survival and overall survival (OS) were 18 months (95% CI: 16-21), 47 months (95% CI: 31-70) and 28 months (95% CI: 22-34) respectively. On multivariable analysis, female gender (HR: 1.5, 95% CI: 1.002-2.21, P = .049) and positive surgical margins (HR: 1.6, 95% CI: 1.06-2.38, P = .026) were the only independent predictor of OS. The type of adjuvant therapy did not impact OS (adjuvant chemotherapy, P = .44; adjuvant radiotherapy, P = .40).

Conclusion

MIBC patients with residual node positive disease following NAC and RC have poor survival outcomes. Females and patients with positive margin status at RC carry a poorer prognosis. These results may be beneficial for clinical trial design.

查看原文本刊更多论文

肌层浸润性膀胱癌新辅助化疗和根治性膀胱切除术后结节受累患者的肿瘤治疗效果：欧洲泌尿外科协会青年泌尿外科医师分会尿路上皮癌工作组（YAU-EAU）的一项多中心观察研究。

直到最近，对于肌肉浸润性膀胱癌（MIBC）的新辅助化疗（NAC）和根治性膀胱切除术（RC）后淋巴结转移（ypN+）患者，还没有推荐的辅助治疗。该研究的目的是描述在NAC和RC治疗MIBC后，ypN+患者的肿瘤学结果。方法本合作回顾性研究纳入了2000年至2019年7个中心的195例NAC术后ypN+疾病患者，并进行了RC和双侧盆腔淋巴结清扫。收集患者的人口学特征、临床和病理特征。采用Kaplan-Meier估计法进行生存分析，并建立Cox模型。结果pN1型120例（62%），pN2型51例（26%），pN3型24例（12%）。辅助放疗18例（9%），辅助化疗40例（21%），观察137例（70%）。中位随访时间为51个月（95% CI: 44-62）。无复发生存期、癌症特异性生存期和总生存期（OS）的中位时间分别为18个月（95% CI: 16-21）、47个月（95% CI: 31-70）和28个月（95% CI: 22-34）。在多变量分析中，女性性别（HR: 1.5, 95% CI: 1.002-2.21, P = 0.049）和阳性手术切缘（HR: 1.6, 95% CI: 1.06-2.38, P = 0.026）是OS的唯一独立预测因子。辅助治疗方式对OS无影响(辅助化疗，P = 0.44；辅助放疗，P = 0.40)。结论mibc患者NAC和RC合并残余淋巴结阳性疾病的生存预后较差。女性和宫颈切缘呈阳性的患者预后较差。这些结果可能对临床试验设计有益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Actas urologicas espanolas UROLOGY & NEPHROLOGY-

CiteScore

1.90

自引率

0.00%

发文量

审稿时长

46 days

期刊介绍： Actas Urológicas Españolas is an international journal dedicated to urological diseases and renal transplant. It has been the official publication of the Spanish Urology Association since 1974 and of the American Urology Confederation since 2008. Its articles cover all aspects related to urology. Actas Urológicas Españolas, governed by the peer review system (double blinded), is published online in Spanish and English. Consequently, manuscripts may be sent in Spanish or English and bidirectional free cost translation will be provided.