Effect of Pembrolizumab on Lymph Node Dissection in Patients Who Experienced Bladder Cancer Recurrence Following Radical Cystectomy.

IF 1.8 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

In vivo Pub Date : 2025-07-01 DOI:10.21873/invivo.14015

Yoshihiko Tasaki, Takashi Nagai, Taku Naiki, Yusuke Noda, Ryosei Okawa, Misato Tomita, Yosuke Sugiyama, Yoshihisa Mimura, Kunihiro Odagiri, Nanami Ito, Yuji Hotta, Nobuhiko Shimizu, Toshiki Etani, Shuzo Hamamoto, Atsushi Okada, Yoko Furukawa-Hibi, Takahiro Yasui

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引用次数: 0

Abstract

Background/aim: Pelvic lymph node dissection is recommended to improve the prognosis in patients with bladder cancer undergoing radical cystectomy. Although several studies have reported an association between lymph node dissection and the efficacy of immune checkpoint inhibitors, evidence specific to bladder cancer remains lacking. This study aimed to investigate the effect of pembrolizumab on lymph node dissection during radical cystectomy in patients with bladder cancer.

Patients and methods: A total of 61 patients treated with pembrolizumab were divided into those who experienced recurrence after radical cystectomy with lymph node dissection (resection group, n=45) and those with unresectable advanced bladder cancer (unresectable group, n=16). The median overall survival (mOS) and progression-free survival (PFS) were analyzed in both groups. Additionally, the association of the characteristics and number of dissected lymph nodes with the efficacy of pembrolizumab was examined in the resection group.

Results: No significant differences were observed in mOS and mPFS between the resection group and the unresectable group (mOS, p=0.90; mPFS, p=0.11, respectively). In the resection group, the mOS and mPFS were not associated with lymph node positivity or negativity (mOS, p=0.52; mPFS, p=0.53, respectively). However, among patients in the resection group who had undergone neoadjuvant therapy, those with >14 resected lymph nodes exhibited significantly shorter mPFS compared with those with <14 resected lymph nodes (p=0.03).

Conclusion: Lymph node resection was not associated with prognosis and efficacy of pembrolizumab in patients with bladder cancer. However, as the resection of more than 14 lymph nodes was associated with a poorer prognosis and reduced efficacy of pembrolizumab, treatment strategies should be carefully tailored based on the extent of lymph node dissection and the administration of neoadjuvant therapy.

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派姆单抗对膀胱癌根治性膀胱切除术后复发患者淋巴结清扫的影响。

背景/目的：盆腔淋巴结清扫被推荐用于改善膀胱癌根治性膀胱切除术患者的预后。尽管有几项研究报道了淋巴结清扫与免疫检查点抑制剂疗效之间的关联，但针对膀胱癌的特异性证据仍然缺乏。本研究旨在探讨派姆单抗对膀胱癌患者根治性膀胱切除术中淋巴结清扫的影响。患者和方法：61例接受pembrolizumab治疗的患者分为根治性膀胱切除术合并淋巴结清扫术后复发患者（切除组，n=45）和不可切除的晚期膀胱癌患者（不可切除组，n=16）。分析两组患者的中位总生存期（mOS）和无进展生存期（PFS）。此外，在切除组中检查了淋巴结清扫的特征和数量与派姆单抗疗效的关系。结果：切除组与不可切除组的mOS和mPFS无显著差异(mOS, p=0.90；mPFS, p=0.11)。在切除组中，mOS和mPFS与淋巴结阳性或阴性无关(mOS, p=0.52；mPFS, p=0.53)。然而，在接受新辅助治疗的切除组患者中，与p=0.03的患者相比，切除bbb14淋巴结的患者mPFS明显更短。结论：淋巴结切除与派姆单抗治疗膀胱癌患者的预后和疗效无关。然而，由于切除超过14个淋巴结与预后较差和派姆单抗疗效降低相关，因此治疗策略应根据淋巴结清扫的程度和新辅助治疗的给药精心定制。

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

In vivo 医学-医学：研究与实验

CiteScore

4.20

自引率

4.30%

发文量

330

审稿时长

3-8 weeks

期刊介绍： IN VIVO is an international peer-reviewed journal designed to bring together original high quality works and reviews on experimental and clinical biomedical research within the frames of physiology, pathology and disease management. The topics of IN VIVO include: 1. Experimental development and application of new diagnostic and therapeutic procedures; 2. Pharmacological and toxicological evaluation of new drugs, drug combinations and drug delivery systems; 3. Clinical trials; 4. Development and characterization of models of biomedical research; 5. Cancer diagnosis and treatment; 6. Immunotherapy and vaccines; 7. Radiotherapy, Imaging; 8. Tissue engineering, Regenerative medicine; 9. Carcinogenesis.