MP03-15 PRIMARY VERSUS SECONDARY MUSCLE INVASIVE BLADDER CANCER: COMPARING THE PATHOLOGIC AND ONCOLOGIC OUTCOMES BETWEEN BOTH FORMS OF MUSCLE INVASIVE DISEASE WHEN TREATED WITH STANDARD OF CARE

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You have accessJournal of UrologyCME1 May 2022MP03-15 PRIMARY VERSUS SECONDARY MUSCLE INVASIVE BLADDER CANCER: COMPARING THE PATHOLOGIC AND ONCOLOGIC OUTCOMES BETWEEN BOTH FORMS OF MUSCLE INVASIVE DISEASE WHEN TREATED WITH STANDARD OF CARE Tarik Benidir, Zaeem Lone, Ao Zhang, Carlos Munoz-Lopez, Pranay Hegde, Kevin Fung, Jesse Fajnzylber, Eric Klein, Mohammed Eltemamy, Jihad Kaouk, Georges Pascal-Haber, Nima Almassi, Christopher Weight, and Byron Lee Tarik BenidirTarik Benidir More articles by this author , Zaeem LoneZaeem Lone More articles by this author , Ao ZhangAo Zhang More articles by this author , Carlos Munoz-LopezCarlos Munoz-Lopez More articles by this author , Pranay HegdePranay Hegde More articles by this author , Kevin FungKevin Fung More articles by this author , Jesse FajnzylberJesse Fajnzylber More articles by this author , Eric KleinEric Klein More articles by this author , Mohammed EltemamyMohammed Eltemamy More articles by this author , Jihad KaoukJihad Kaouk More articles by this author , Georges Pascal-HaberGeorges Pascal-Haber More articles by this author , Nima AlmassiNima Almassi More articles by this author , Christopher WeightChristopher Weight More articles by this author , and Byron LeeByron Lee More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002515.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Primary muscle invasive bladder cancer (P-MIBC) is the most common presentation at initial consultation; however, a subset of patients progress to MIBC following initial management for non-muscle invasive bladder cancer (NMIBC). The latter has been coined secondary MIBC (S-MIBC) and may exhibit decreased sensitivity to cisplatin-based chemotherapy. We aimed to explore response to neoadjuvant chemotherapy (NAC) and oncologic outcomes between P-MIBC and S-MIBC patients receiving radical cystectomy at a high-volume tertiary care center. METHODS: We performed a retrospective review of radical cystectomy (RC) patients from 2010 to 2019 who were cT2-T4/N0 and treated with a cisplatin-based NAC regimen. Patients were defined as S-MIBC if they had history of NMBIC, were treated with at least one course of induction BCG, and progressed to MIBC. Our primary outcomes of interest were down-staging rates, which was defined as <pT2/N0, and complete pathologic response (pT0/N0). Secondary outcomes of interest were cancer specific survival (CSS), overall survival (OS), and recurrence free survival (RFS). Categorical variables were compared with the Pearson-Chi Square test. Survival outcomes were assessed using the Kaplan-Meier method with log rank. Multivariate Cox Proportional Hazards models were utilized to identify predictors of survival outcomes. RESULTS: 333 patients were included (48 S-MIBC vs. 285 P-MIBC). Following NAC and RC, there were no differences in down-staging rates between both groups (S-MIBC: 54% vs. P-MIBC: 51%, p=0.67). There was no difference in complete pathologic response rates between the two groups (S-MIBC: 33% vs. P-MIBC: 28%, p=0.41). There were no differences in CSS (p=0.97), OS (p=0.94), or RFS (p=0.83). On Cox Proportional Hazards regression, only ³ pT2 and N+ disease predicted poorer CSS, OS, and RFS. CONCLUSIONS: S-MIBC is an uncommon presentation as compared to P-MIBC. In our patient population, there were no differences between P-MIBC and S-MIBC with respect to cisplatin sensitivity and oncologic outcomes. Future studies should focus on molecular biomarkers that can predict NAC response in these patients. Source of Funding: N/A © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e26 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tarik Benidir More articles by this author Zaeem Lone More articles by this author Ao Zhang More articles by this author Carlos Munoz-Lopez More articles by this author Pranay Hegde More articles by this author Kevin Fung More articles by this author Jesse Fajnzylber More articles by this author Eric Klein More articles by this author Mohammed Eltemamy More articles by this author Jihad Kaouk More articles by this author Georges Pascal-Haber More articles by this author Nima Almassi More articles by this author Christopher Weight More articles by this author Byron Lee More articles by this author Expand All Advertisement PDF DownloadLoading ...