MP46-05 GENDER, RACIAL AND ETHNIC DIFFERENCES IN PATHOLOGIC RESPONSE FOLLOWING NEOADJUVANT CHEMOTHERAPY FOR BLADDER CANCER PATIENTS

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP46-05 GENDER, RACIAL AND ETHNIC DIFFERENCES IN PATHOLOGIC RESPONSE FOLLOWING NEOADJUVANT CHEMOTHERAPY FOR BLADDER CANCER PATIENTS Irasema Paster, Jiping Zeng, Alejandro Recio-Boiles, and Juan Chipollini Irasema PasterIrasema Paster More articles by this author , Jiping ZengJiping Zeng More articles by this author , Alejandro Recio-BoilesAlejandro Recio-Boiles More articles by this author , and Juan ChipolliniJuan Chipollini More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003292.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The purpose of this study was to evaluate nationwide trends in pathologic complete response (CR) racial variations in patients with muscle-invasive bladder cancer (MIBC) undergoing cystectomy. METHODS: The National Cancer Database was queried for patients from 2004 to 2016 with non-metastatic MIBC who underwent neoadjuvant chemotherapy and definitive surgery. The primary endpoints, CR and mortality, were evaluated using Cochran-Armitage test, multivariable regression, and Kaplan-Meier analyses. RESULTS: The final analytic cohort was 9,955 patients. Non-Hispanic black (NHB) patients presented with younger age (p<0.001), higher comorbidity score (p=0.036), and higher clinical tumor (cT) stage (p<0.001). The overall CR rate was highest for non-Hispanic white (NHW) males (13.4%) while Hispanic white (HW) females and NHB males had lower CR rates (both, 9.1%). There was a significant increase in CR trends for NHW patients (p<0.001), and non-significant increases for NHB (p=0.311) and Hispanic patients (p=0.236). On multivariable analysis, NHW females had significantly lower odds of achieving CR (OR; 0.83, 95%CI 0.71-0.97); however, NHB males (HR: 1.21, 1.01-1.44) and NHB females (HR: 1.25, 1.03-1.53) had higher overall mortality on adjusted analysis. Overall survival differences were not seen in patients who achieved CR regardless of racial background; however, for those with residual disease, the 2-year survival probabilities were 60.7, 62.5, and 51.1% for NHW, HW, and NHB patients, respectively (log-rank p=0.010). CONCLUSIONS: Our findings showed differences in chemotherapy response based on gender and race/ethnicity. The trends in CR for all racial/ethnic groups appear to be increasing over time. However, even after guideline-directed care, black patients were found with worse survival particularly when residual disease is present. Clinical studies with more underrepresented minorities are needed to verify biological differences in response and help mitigate potential socioeconomic disparities in MIBC. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e632 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Irasema Paster More articles by this author Jiping Zeng More articles by this author Alejandro Recio-Boiles More articles by this author Juan Chipollini More articles by this author Expand All Advertisement PDF downloadLoading ...