Abstract
4537 Background: Few studies have documented regimens used and timing of peri-operative chemotherapy for MIBC in routine practice. In metastatic bladder cancer cisplatin has superior efficacy to carboplatin. Time to initiation of adjuvant chemotherapy (TTAC) from surgery is known to be associated with survival in other solid tumors. Here we describe regimens used and TTAC in the general population of Ontario, Canada. Methods: Treatment and physician billing records were linked to the Ontario Cancer Registry to describe use of neoadjuvant (NACT) and adjuvant (ACT) chemotherapy among all patients with MIBC treated with cystectomy in Ontario 1994-2008. Time to initiation of ACT (TTAC) was measured from cystectomy. Multivariate Cox regression was used to identify factors associated with overall (OS) and cancer-specific survival (CSS). Results: Of 2944 patients undergoing cystectomy, 4% (129/2944) and 19% (571/2944) were treated with NACT and ACT respectively. Five-year OS was 25% (95%CI 17-34%) for NACT, 29% ...
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