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Preoperative chemotherapy is underused in conjunction with radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC) due to concerns for complications and delay of surgery. Prospective data on short-term complications from population-based settings with frequent use of preoperative chemotherapy and standardised reporting of complications is lacking.
We identified 1,340 patients who underwent RC between 2011 and 2015 in Sweden due to MIBC according to the Swedish Cystectomy Register. These individuals were followed through linkages to several national registers. Propensity score adjusted logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for complications and death within 90 days of surgery, comparing patients receiving preoperative chemotherapy or not.
Minimum two cycles of preoperative chemotherapy were given to 519 (39%) of the patients, who on average tended to be younger, have higher education, better physical status, and more advanced bladder cancer than patients not receiving chemotherapy. After adjusting for these and other parameters, there was no association between treatment with preoperative chemotherapy and short-term complications (OR 1.06 95% CI 0.82–1.39) or mortality (OR 0.75 95% CI 0.36–1.55). We observed a risk reduction for gastrointestinal complications among patients who received preoperative chemotherapy compared with those who did not (OR 0.49 95% CI 0.30–0.81).
This nation-wide population-based observational study does not suggest that preoperative chemotherapy, in a setting with high utilisation of such treatment, is associated with an increased risk of short-term complications in MIBC patients treated with radical cystectomy.
Alfred Witjes J, Lebret T, Comperat EM, Cowan NC, De Santis M, Bruins HM et al (2017) Updated 2016 EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer. Eur Urol 71(3):462–475 CrossRef
Stenzl A, Cowan NC, De Santis M, Jakse G, Kuczyk MA, Merseburger AS et al (2009) The updated EAU guidelines on muscle-invasive and metastatic bladder cancer. Eur Urol 55(4):815–825 CrossRef
Zargar H, Espiritu PN, Fairey AS, Mertens LS, Dinney CP, Mir MC et al (2015) Multicenter assessment of neoadjuvant chemotherapy for muscle-invasive bladder cancer. Eur Urol 67(2):241–249 CrossRef
Liedberg F, Gudjonsson S, Kollberg P, Ullen A (2015) A plea for uniform terminology for patients with urothelial carcinoma treated with chemotherapy prior to radical cystectomy: induction versus neoadjuvant chemotherapy. Eur Urol 68(4):742–743 CrossRef
Konety BR, Allareddy V, Herr H (2006) Complications after radical cystectomy: analysis of population-based data. Urology. 68(1):58–64 CrossRef
Lawrentschuk N, Colombo R, Hakenberg OW, Lerner SP, Mansson W, Sagalowsky A et al (2010) Prevention and management of complications following radical cystectomy for bladder cancer. Eur Urol 57(6):983–1001 CrossRef
Hautmann RE, de Petriconi RC, Volkmer BG (2010) Lessons learned from 1,000 neobladders: the 90-day complication rate. J Urol 184(3):990–994 (quiz 1235) CrossRef
Djaladat H, Katebian B, Bazargani ST, Miranda G, Cai J, Schuckman AK et al (2017) 90-Day complication rate in patients undergoing radical cystectomy with enhanced recovery protocol: a prospective cohort study. World J Urol 35(6):907–911 CrossRef
Elmussareh M, Simonsen PC, Young M, Kingo PS, Jakobsen JK, Jensen JB (2019) Correlation between organ-specific co-morbidities and complications in bladder cancer patients undergoing radical cystectomy. Scand J Urol 1–6
Shabsigh A, Korets R, Vora KC, Brooks CM, Cronin AM, Savage C et al (2009) Defining early morbidity of radical cystectomy for patients with bladder cancer using a standardized reporting methodology. Eur Urol 55(1):164–174 CrossRef
Grossman HB, Natale RB, Tangen CM, Speights VO, Vogelzang NJ, Trump DL et al (2003) Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med 349(9):859–866 CrossRef
Neoadjuvant cisplatin, methotrexate, and vinblastine chemotherapy for muscle-invasive bladder cancer: a randomised controlled trial. International collaboration of trialists
Kitamura H, Tsukamoto T, Shibata T, Masumori N, Fujimoto H, Hirao Y et al (2014) Randomised phase III study of neoadjuvant chemotherapy with methotrexate, doxorubicin, vinblastine and cisplatin followed by radical cystectomy compared with radical cystectomy alone for muscle-invasive bladder cancer: Japan Clinical Oncology Group Study JCOG0209. Ann Oncol 25(6):1192–1198 CrossRef
Gandaglia G, Popa I, Abdollah F, Schiffmann J, Shariat SF, Briganti A et al (2014) The effect of neoadjuvant chemotherapy on perioperative outcomes in patients who have bladder cancer treated with radical cystectomy: a population-based study. Eur Urol 66(3):561–568 CrossRef
Johnson DC, Nielsen ME, Matthews J, Woods ME, Wallen EM, Pruthi RS et al (2014) Neoadjuvant chemotherapy for bladder cancer does not increase risk of perioperative morbidity. BJU Int. 114(2):221–228 CrossRef
Tyson MD 2nd, Bryce AH, Ho TH, Carballido EM, Castle EP (2014) Perioperative complications after neoadjuvant chemotherapy and radical cystectomy for bladder cancer. Can J Urol. 21(3):7259–7265 PubMed
Salminen AP, Koskinen I, Perez IM, Hurme S, Murtola TJ, Vaarala MH, et al (2018) Neoadjuvant chemotherapy does not increase the morbidity of radical cystectomy: a 10-year retrospective nationwide study. European Urology Oncology
Milenkovic U, Akand M, Moris L, Demaegd L, Muilwijk T, Bekhuis Y, et al (2018) Impact of neoadjuvant chemotherapy on short-term complications and survival following radical cystectomy. World J Urol
Griffiths G, Hall R, Sylvester R, Raghavan D, Parmar MK (2011) International phase III trial assessing neoadjuvant cisplatin, methotrexate, and vinblastine chemotherapy for muscle-invasive bladder cancer: long-term results of the BA06 30894 trial. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 29(16):2171–2177 CrossRef
Sherif A, Holmberg L, Rintala E, Mestad O, Nilsson J, Nilsson S et al (2004) Neoadjuvant cisplatinum based combination chemotherapy in patients with invasive bladder cancer: a combined analysis of two Nordic studies. Eur Urol 45(3):297–303 CrossRef
Patafio FM, Mackillop WJ, Feldman-Stewart D, Siemens DR, Booth CM (2014) Why is perioperative chemotherapy for bladder cancer underutilized? Urol Oncol. 32(4):391–395 CrossRef
Porter MP, Kerrigan MC, Donato BM, Ramsey SD (2011) Patterns of use of systemic chemotherapy for Medicare beneficiaries with urothelial bladder cancer. Urol Oncol. 29(3):252–258 CrossRef
Jerlstrom T, Gardmark T, Carringer M, Holmang S, Liedberg F, Hosseini A et al (2014) Urinary bladder cancer treated with radical cystectomy: perioperative parameters and early complications prospectively registered in a national population-based database. Scand J Urol. 48(4):334–340 CrossRef
Abstracts (2017) Scandinavian Journal of Urology 51(220):15–64
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213 CrossRef
Hautmann RE, de Petriconi RC, Pfeiffer C, Volkmer BG (2012) Radical cystectomy for urothelial carcinoma of the bladder without neoadjuvant or adjuvant therapy: long-term results in 1100 patients. Eur Urol 61(5):1039–1047 CrossRef
van Hemelrijck M, Thorstenson A, Smith P, Adolfsson J, Akre O (2013) Risk of in-hospital complications after radical cystectomy for urinary bladder carcinoma: population-based follow-up study of 7608 patients. BJU Int. 112(8):1113–1120 CrossRef
Klinga G, Sherif A (2016) A retrospective evaluation of preoperative anemia in patients undergoing radical cystectomy for muscle-invasive urothelial urinary bladder cancer, with or without neoadjuvant chemotherapy. Springerplus. 5(1):1167 CrossRef
Chughtai M, Gwam CU, Mohamed N, Khlopas A, Newman JM, Khan R et al (2017) The Epidemiology and Risk Factors for Postoperative Pneumonia. J Clin Med Res. 9(6):466–475 CrossRef
Kollberg P, Almquist H, Blackberg M, Cwikiel M, Gudjonsson S, Lyttkens K et al (2017) [(18)F]Fluorodeoxyglucose-positron emission tomography/computed tomography response evaluation can predict histological response at surgery after induction chemotherapy for oligometastatic bladder cancer. Scand J Urol. 51(4):308–313 CrossRef
- No increased risk of short-term complications after radical cystectomy for muscle-invasive bladder cancer among patients treated with preoperative chemotherapy: a nation-wide register-based study
Firas A. S. Aljabery
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