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Erschienen in: World Journal of Urology 9/2019

05.12.2018 | Original Article

Impact of neoadjuvant chemotherapy on short-term complications and survival following radical cystectomy

verfasst von: Uros Milenkovic, Murat Akand, Lisa Moris, Liesbeth Demaegd, Tim Muilwijk, Youri Bekhuis, Annouschka Laenen, Ben Van Cleynenbreugel, Wouter Everaerts, Hein Van Poppel, Herlinde Dumez, Maarten Albersen, Steven Joniau

Erschienen in: World Journal of Urology | Ausgabe 9/2019

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Abstract

Objectives

To compare perioperative and short-term postoperative complication rates between patients receiving radical cystectomy (RC) after neoadjuvant chemotherapy (NAC) and patients undergoing RC alone. Secondary objectives were to compare overall survival (OS) and cancer-specific survival (CSS).

Materials and methods

Clinico-pathological data of all patients who received RC between 1996 and 2015 were retrospectively collected. Only patients with RC for muscle-invasive bladder cancer were included in the final analysis. Short-term (30-day) postoperative complications were assessed by registering the Clavien–Dindo classification (CDC) and dividing into sub-groups: low-grade (LGC) CDC 1–2 and high-grade (HGC) CDC 3–5. To compare populations with similar age, comorbidities and preoperative creatinine, we used a propensity score-adjusted statistical model. Pre- and perioperative predictors of short-term complications were identified using uni- and multivariable models. Survival was assessed using Kaplan–Meier analysis.

Results

A total of 491 patients undergoing RC were included, of whom 102 (20.8%) received NAC. After propensity score covariate adjustment, there was no significant difference in postoperative complications between patients undergoing NAC plus RC and RC alone with an overall complication rate of 69% and 66%, respectively. No significant differences in the 30-day HGC rates (11.76% and 11.83%, respectively) were observed. NAC plus RC patients had worse prognostic factors at baseline; nevertheless, after correction for group differences OS and CSS did not differ from RC only group (5-year OS 61.3% vs. 50.2%, and 5-year CSS 61.8% vs. 57.9% respectively, p > 0.05 for all).

Conclusion

In appropriately selected patients, exposure to NAC is not associated with increased short-term complications.
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Metadaten
Titel
Impact of neoadjuvant chemotherapy on short-term complications and survival following radical cystectomy
verfasst von
Uros Milenkovic
Murat Akand
Lisa Moris
Liesbeth Demaegd
Tim Muilwijk
Youri Bekhuis
Annouschka Laenen
Ben Van Cleynenbreugel
Wouter Everaerts
Hein Van Poppel
Herlinde Dumez
Maarten Albersen
Steven Joniau
Publikationsdatum
05.12.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 9/2019
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-018-2584-0

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