AUA 2017: Incompleteness Of The Transurethral Resection As A Predictor Of Adverse Pathological Features At The Time Of Radical Cystectomy: Implications For Neoadjuvant Chemotherapy Selection
This was a retrospective study assessing 481 patients treated with RC and bilateral pelvic lymph node dissection due to non-metastatic bladder cancer between 1990 and 2013 without NAC. Data regarding the completeness of pre-cystectomy TUR was attained. TUR were completed when possible, however, when not feasible, physicians reported this in a prospective maintained database.
Overall, TUR had been completed in 326 (67.8%) patients subsequently undergoing RC. Patients with an uncompleted TUR had higher cT3-4 disease, LVI, CIS and worse cN+ diseases. In univariate analysis, incompleteness of TUR was a predictor of LNI (odds ratio [OR]: 1.66, confidence interval [CI]: 1.08-2.55, p=0.02), adverse pathologic stage (OR: 1.78, CI: 1.21-2.62, p=0.003), and positive STSM (OR: 2.15, CI: 1.13-4.10, p=0.02). Multivariate analysis demonstrated that lack of TUR completeness was a predictor of positive STSM (OR: 2.18, CI: 1.12-4.25, p=0.02) and adverse pathologic T stage (OR: 1.57, CI: 1.03-2.40, p=0.03) but not of LNI (p=0.06).
In summary, incomplete TUR before RC represents a predictor of adverse pathologic features at RC. Physicians should consider this when trying to predict RC patients' survival and eventually the necessity of neoadjuvant chemotherapy administration.
Presented By: Marco Moschini, Milan, Italy
Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre
Twitter: @Goldberghanan
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA