AUA 2017: Dose Dense Mvac Prior To Radical Cystectomy: A Retrospective Multi-institutional Experience
This was a retrospective study assessing patients from seven contributing institutions from 2000-2015. Only patients with cT2-4a, M0 BCa were included. The authors defined high risk disease if any of the following was present: presence of cT3-4 disease, hydronephrosis, lymphovascular invasion and/or existence of sarcomatoid, or micropapillary features on the initial transurethral resection of bladder tumor specimen. Logistic regression models for prediction of complete pathological response (pT0N0) and partial pathological response (≤pT1N0) were generated for the entire cohort as well as for the cN0 subgroup. The multivariable Cox proportional hazards regression model for survival using post RC data was used to assess hazard ratios (HRs) for the variables of interest.
Overall 345 patients received ddMVAC chemotherapy during the study period. The observed rates of pT0N0 and ≤pT1N0 were 30.4% and 49.3%, respectively among cN0 patients. On the multivariable regression model, the presence of more than one clinical high-risk element was associated with 70% (OR 0.30 95%CI (0.10-0.86); p=0.02) reduction in the probability of achieving partial pathological response.
Dr. Zargar concluded his presentation by stating that a complete response (pT0N0) was observed in one third of patients after neoadjuvant ddMVAC therapy, and a partial response (≤pT1N0) was observed in nearly half of the cases.
Presented By: Homayoun Zargar, Vancouver, Canada
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