[Impact of neoadjuvant chemotherapy on the peri-operative morbidity of radical cystectomy for muscle invasive bladder cancer]

Platinum-based neoadjvant chemotherapy (NAC) before radical cystectomy (RC) is the gold standard in the treatment of muscle invasive bladder cancer (MIBC). We aimed to compare the peri-operative morbidity in patients treated by NAC then RC and patients having RC alone.

Between 1st January 2008 and 31st December 2015, we retrospectively included consecutive patients undergoing RC for MIBC in 2centers. We collected clinical, pathological and peri-operative data (30day post operative complications according to the Clavien-Dindo score, delayed complications, pathological results). Patients treated by NAC (NAC-RC group) before RC were compared to patients performing RC alone. The NAC-RC group received 1 to 6cycle of high-dose MVAC, MVAC or gemcitabine-cisplatine chemotherapy. Logistic regression identified independant factors of peri-operative complications.

We included 199 patients: 48in the NAC-RC group and 151in the RC group. Complications rate was 73.9% in the NAC-RC group versus 73.8% in the RC group (P=1.0). In multivariate analyses, only the Charlson score was associated with an increased risk of peri-operative complications (P=0.05). PT0 tumour rate was significantly higher in the NAC-CR group (50% vs 7%, P<0.001).

NAC does not increase the peri-operative morbidity of the RC. Patients' pre operative comorbidities is the main risk factor for peri-operative complications.

Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2018 Jul 08 [Epub ahead of print]

C Michel, D Vordos, C Dumont, V Basset, F Meyer, F Gaudez, P Meria, A Cortesse, P Mongiat-Artus, A de la Taille, S Culine, F Desgrandchamps, A Masson-Lecomte

Service d'urologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: ., Service d'urologie, hôpital Henri-Mondor, 31, rue du Parc, 94000 Créteil, France. Electronic address: ., Service d'oncologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: ., Service d'urologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: ., Service d'urologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France., Service d'urologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: ., Service d'urologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: ., Service d'urologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: ., Service d'urologie, hôpital Henri-Mondor, 31, rue du Parc, 94000 Créteil, France. Electronic address: ., Service d'urologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: ., Service d'oncologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France., Service d'urologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: ., Service d'urologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: .