You have accessJournal of UrologyBladder Cancer: Invasive II1 Apr 2014MP55-18 ADJUVANT CHEMOTHERAPY AFTER RADICAL CYSTECTOMY FOR MUSCLE-INVASIVE BLADDER CANCER: A COMPARATIVE STUDY USING INVERSE-PROBABILITY-OF-TREATMENT WEIGHTING (IPTW) Taekmin Kwon, In Gab Jeong, Dalsan You, Bumjin Lim, Chunwoo Lee, Kyung-Sik Han, Sungwoo Hong, Bumsik Hong, Jun Hyuk Hong, Myung-Soo Choo, Hanjong Ahn, Tai Young Ahn, and Choung-Soo Kim Taekmin KwonTaekmin Kwon More articles by this author , In Gab JeongIn Gab Jeong More articles by this author , Dalsan YouDalsan You More articles by this author , Bumjin LimBumjin Lim More articles by this author , Chunwoo LeeChunwoo Lee More articles by this author , Kyung-Sik HanKyung-Sik Han More articles by this author , Sungwoo HongSungwoo Hong More articles by this author , Bumsik HongBumsik Hong More articles by this author , Jun Hyuk HongJun Hyuk Hong More articles by this author , Myung-Soo ChooMyung-Soo Choo More articles by this author , Hanjong AhnHanjong Ahn More articles by this author , Tai Young AhnTai Young Ahn More articles by this author , and Choung-Soo KimChoung-Soo Kim More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1566AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives The role of adjuvant chemotherapy after radical cystectomy remains poorly defined for the management of muscle-invasive bladder cancer (MIBC). The purpose of the study was to evaluate the benefit of cisplatin based adjuvant chemotherapy (AC) versus surgery alone in patients with MIBC. Methods The medical records of 701 patients who underwent radical cystectomy for MIBC were reviewed. We analyzed the association of AC after surgery with survival using the Cox regression models. To reduce the impact of treatment selection bias and potential confounding in an observational study, we performed rigorous adjustment for significant differences in patient characteristics by using inverse-probability-of-treatment weighting (IPTW). Results A total of 701 patients (623 men and 78 women) with a mean age of 62.4 years were uniformly treated. Median follow-up was 64.3 months (range, 1 to 231.4 months). Of the 701 patients, 161 (22.9%) patients received AC after cystectomy (AC group) and 540 patients (77.1%) underwent cystectomy alone (non AC group). The AC group patients were younger (60 vs. 63 years, p=0.001) and more likely to have high pathologic T stage (87.0 vs. 32.6%, p=0.001), lymph node metastasis (73.9 vs. 11.2%, p=0.001), high grade (96.9 vs. 82.4%, p=0.001) and lymphovascular invasion (73.8 vs. 32.6%, p=0.001) compared to non AC group patients. In univariate analysis, AC improved survival in high pathologic T stage (¡ÃT3) and lymph node metastasis. In multivariable analysis of predicting for overall survival, AC showed a survival benefit (HR 0.616 95% CI 0.413-0.919 p=0.0176) along with low pathologic T stage, no lymph node metastasis and no lymphovascular invasion. After adjustment for baseline patients¡¯ characteristics with IPTW, AC was an independent predictor of overall survival (HR 0.807 CI 0.670-0.971 p=0.0234). Conclusions The present study showed that after adjusting for confounding variables using IPTW anlaysis, further evidence of an overall survival benefit in patients with MIBC receiving adjuvant cisplatin-based chemotherapy after radical cystectomy. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e562 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Taekmin Kwon More articles by this author In Gab Jeong More articles by this author Dalsan You More articles by this author Bumjin Lim More articles by this author Chunwoo Lee More articles by this author Kyung-Sik Han More articles by this author Sungwoo Hong More articles by this author Bumsik Hong More articles by this author Jun Hyuk Hong More articles by this author Myung-Soo Choo More articles by this author Hanjong Ahn More articles by this author Tai Young Ahn More articles by this author Choung-Soo Kim More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...