Surgery after neoadjuvant chemotherapy for muscle invasive bladder cancer: clinicopathological and surgical outcomes

Adel Denewer; Khalid Atallah; Khaled Abdel Wahab; Emad Hamed; Basel Refky; Amr Abouzid; Ziad Emarah; Mona Zaky; Mohamed Saad Elashry; Mie Mohamed; Mahmoud Abdel Aziz; Mohamed Elmetwally; Sameh Roshdy

doi:10.18203/2349-2902.isj20183716

Authors

Adel Denewer Department of Surgical Oncology, Mansoura Oncology Centre, Mansoura University, Mansoura, Egypt
Khalid Atallah Department of Surgical Oncology, Mansoura Oncology Centre, Mansoura University, Mansoura, Egypt
Khaled Abdel Wahab Department of Surgical Oncology, Mansoura Oncology Centre, Mansoura University, Mansoura, Egypt
Emad Hamed Department of Surgical Oncology, Mansoura Oncology Centre, Mansoura University, Mansoura, Egypt
Basel Refky Department of Surgical Oncology, Mansoura Oncology Centre, Mansoura University, Mansoura, Egypt
Amr Abouzid Department of Surgical Oncology, Mansoura Oncology Centre, Mansoura University, Mansoura, Egypt
Ziad Emarah Department of Medical Oncology, Mansoura Oncology Center, Mansoura University, Egypt
Mona Zaky Department of Diagnostic and Interventional Radiology, Mansoura University, Mansoura, Egypt
Mohamed Saad Elashry Department of Clinical Oncology and Nuclear Medicine, Mansoura University hospital, Mansoura university, Egypt
Mie Mohamed Department of Pathology, Faculty of Medicine, Mansoura University, Egypt
Mahmoud Abdel Aziz Department of Surgical Oncology, Mansoura Oncology Centre, Mansoura University, Mansoura, Egypt
Mohamed Elmetwally Department of Surgical Oncology, Mansoura Oncology Centre, Mansoura University, Mansoura, Egypt
Sameh Roshdy Department of Surgical Oncology, Mansoura Oncology Centre, Mansoura University, Mansoura, Egypt

DOI:

https://doi.org/10.18203/2349-2902.isj20183716

Keywords:

Muscle invasive bladder cancer, Neoadjuvant chemotherapy, Urinary diversion

Abstract

Background: Neoadjuvant chemotherapy (NAC) before radical cystectomy (RC) is the standard of care for muscle-invasive bladder cancer (MIBC) owing to the survival advantage, which has correlated with down-staging of the cancer to pT0. This approach is underused because it may be associated with increased perioperative morbidity and mortality rates. This study was designed to evaluate NAC plus RC regarding pathological response, perioperative morbidity and mortality outcomes.

Methods: This is a prospective study that was carried out from August 2015 till July 2017 for patients with bladder carcinoma. We enrolled all cases with ≥ T2 bladder receiving NAC. Patients with metastatic disease, poor performance were excluded from this study.

Results: pathological response rate and Complications occurred within 30 and 90 d after surgery. Heterologous blood transfusions, length of stay, readmission, and perioperative morbidity, and mortality were compared.

Conclusions: Our results suggest that non-urothelial tumor showed no response to Platinum based combination chemotherapeutic regimens. NAC followed by RC gives no more perioperative complications.

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