You have accessJournal of UrologyBladder Cancer: Invasive VI (PD60)1 Apr 2020PD60-04 SURVIVAL ANALYSIS AND PREDICTORS OF NON-MUSCLE INVASIVE BLADDER CANCER RECURRENCE IN CLINICAL COMPLETE-RESPONDERS AFTER NEOADJUVANT CHEMOTHERAPY FOR MUSCLE-INVASIVE BLADDER CANCER Helena Vila-Reyes*, Kevin Lee, G.Joel Decastro, Gen Li, Christopher R. Haas, Jamie S. Pak, Izak Faiena, Christopher B. Anderson, and James M. McKiernan Helena Vila-Reyes*Helena Vila-Reyes* More articles by this author , Kevin LeeKevin Lee More articles by this author , G.Joel DecastroG.Joel Decastro More articles by this author , Gen LiGen Li More articles by this author , Christopher R. HaasChristopher R. Haas More articles by this author , Jamie S. PakJamie S. Pak More articles by this author , Izak FaienaIzak Faiena More articles by this author , Christopher B. AndersonChristopher B. Anderson More articles by this author , and James M. McKiernanJames M. McKiernan More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000977.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical cystectomy (RC) with neoadjuvant chemotherapy (NAC) is the gold standard treatment for muscle-invasive bladder cancer (MIBC), but 30-40% of the patients achieve a clinical complete response (cCR) after NAC. In cT0 patients who elect bladder preservation, non-muscle invasive (NMIBC) and MIBC relapses may appear during the follow-up. The outcomes of MIBC relapse have been extensively assessed, while NMIBC have been less studied. We report the outcomes and predictive factors related to NMIBC recurrence in patients with cCR following NAC for MIBC who elected surveillance. METHODS: We retrospectively reviewed our cohort of cCR after NAC for MIBC, and selected patients who chose subsequent bladder preservation. Clinical T0 status was assessed with negative re-TURBT, cytology and imaging after NAC. Patients with immediate partial or RC post-NAC and those with positive lymph nodes or metastases pre-NAC, were excluded. Uni- and multivariate models were used to identify predictive factors of NMIBC recurrence and response rate to BCG-treatment. Kaplan Meier estimator and log-rank test were used for survival analysis. RESULTS: We identified 60 patients with cCR from 2001-2019, with a median follow-up of 51.4 mo (IQR 26.3-79.5). Median age at diagnosis was 70 years (IQR 63-75) and 50 (83%) were men. Nine (15%) patients experienced MIBC relapse and were excluded from the study. 51 patients were finally analyzed. Thirteen (25%) patients had previous NMIBC history and 85% of them had received BCG at some point before NAC. Twenty-five (49%) experienced NMIBC recurrences. Only the presence of CIS before NAC was a predictive factor for NMIBC recurrence (OR 4.28 (95% CI [1.07-17.14], p=0.04). Fifteen (60%) patients received BCG, with stages: cTa - 5 (33%), cT1 - 1 (7%) and cTis - 9 (60%). 7 of them (47%) had complete durable responses (median follow-up of 67.4 months). Patients who had CIS at TURBT pre-NAC had a non-significant trend to lower response to BCG (OR 0.13 (95% CI [0.01-1.33], p=0.086). When comparing the NMIBC group with those who did not recur, no differences were observed in terms of metastases-FS, CSS and OS (p=0.26, 0.70 and 0.50, respectively). CONCLUSIONS: Patients with previous MIBC and cCR to NAC who had NMIBC recurrence don’t seem to have a worse MFS, CSS or OS, when compared to those who did not recur. Only CIS pre-NAC was identified as a factor for NMIBC recurrence. Larger series are necessary to identify if there is any predictive factor for BCG-response in NMIBC recurrences following cCR. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1274-e1274 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Helena Vila-Reyes* More articles by this author Kevin Lee More articles by this author G.Joel Decastro More articles by this author Gen Li More articles by this author Christopher R. Haas More articles by this author Jamie S. Pak More articles by this author Izak Faiena More articles by this author Christopher B. Anderson More articles by this author James M. McKiernan More articles by this author Expand All Advertisement PDF downloadLoading ...