PD55-12 NEOADJUVANT CHEMOTHERAPY FOR VARIANT HISTOLOGY MUSCLE INVASIVE BLADDER CANCER: PATHOLOGIC DOWNSTAGING AND SURVIVAL OUTCOMES

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive IV (PD55)1 Sep 2021PD55-12 NEOADJUVANT CHEMOTHERAPY FOR VARIANT HISTOLOGY MUSCLE INVASIVE BLADDER CANCER: PATHOLOGIC DOWNSTAGING AND SURVIVAL OUTCOMES Nicholas Chakiryan, David Jiang, Kyle Gillis, Elizabeth Green, Ali Hajiran, Lee Hugar, Logan Zemp, Jad Chahoud, Jingsong Zhang, Rohit Jain, Brandon Manley, Wade Sexton, and Scott Gilbert Nicholas ChakiryanNicholas Chakiryan More articles by this author , David JiangDavid Jiang More articles by this author , Kyle GillisKyle Gillis More articles by this author , Elizabeth GreenElizabeth Green More articles by this author , Ali HajiranAli Hajiran More articles by this author , Lee HugarLee Hugar More articles by this author , Logan ZempLogan Zemp More articles by this author , Jad ChahoudJad Chahoud More articles by this author , Jingsong ZhangJingsong Zhang More articles by this author , Rohit JainRohit Jain More articles by this author , Brandon ManleyBrandon Manley More articles by this author , Wade SextonWade Sexton More articles by this author , and Scott GilbertScott Gilbert More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002089.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients with variant histology muscle invasive bladder cancer (MIBC) have a poor prognosis. It is unclear if neoadjuvant chemotherapy prior to radical cystectomy, the standard of care for pure urothelial MIBC, is associated with pathologic downstaging or improved overall survival for patients with variant histology. The primary objective is to assess for associations between receipt of neoadjuvant chemotherapy, pathologic downstaging, and overall survival for patients with variant histology MIBC. METHODS: This retrospective study identified patients in the National Cancer Database from 2004-2017 with MIBC, without metastases, who underwent radical cystectomy. Patients were stratified by histologic subgroup, and receipt or non-receipt of neoadjuvant chemotherapy. Multivariable logistic regression analysis determined associations between neoadjuvant chemotherapy and pathologic downstaging. Multivariable Cox regression analysis determined associations between neoadjuvant chemotherapy and overall survival. The main outcomes were pathologic downstaging, defined as pT0N0 or pT≤1N0, and overall survival from the time of diagnosis to date of death or censoring at last follow-up RESULTS: 31,218 patients were included in the final study population (Urothelial carcinoma (UC): 27,779; Sarcomatoid UC: 501; Micropapillary UC: 418; Squamous cell carcinoma (SCC): 1,141; Neuroendocrine carcinoma: 629; Adenocarcinoma: 750). Neoadjuvant chemotherapy was associated with pathologic downstaging to pT0N0 in all histologic subgroups (UC: OR 5.1 [4.6-5.6]; Sarcomatoid UC: OR 13.8 [5.5-39.0]; Micropapillary UC: OR 9.7 [2.8-46.8]; SCC: OR 7.4 [2.1-24.5]; Neuroendocrine: OR 4.7 [2.6-9.2]; Adenocarcinoma: OR 23.3 [8.0-74.2]). Neoadjuvant chemotherapy was associated with improved overall survival for UC (HR 0.8 [0.77-0.84]), sarcomatoid UC (HR 0.64 [0.44-0.91]), and neuroendocrine carcinoma (HR 0.55 [0.43-0.70]). CONCLUSIONS: Neoadjuvant chemotherapy was associated with pathologic downstaging for all MIBC histologic variants, with improved overall survival for patients with UC, sarcomatoid variant UC, and neuroendocrine carcinoma. Source of Funding: NA © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1002-e1002 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nicholas Chakiryan More articles by this author David Jiang More articles by this author Kyle Gillis More articles by this author Elizabeth Green More articles by this author Ali Hajiran More articles by this author Lee Hugar More articles by this author Logan Zemp More articles by this author Jad Chahoud More articles by this author Jingsong Zhang More articles by this author Rohit Jain More articles by this author Brandon Manley More articles by this author Wade Sexton More articles by this author Scott Gilbert More articles by this author Expand All Advertisement Loading ...