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Neoadjuvant Chemotherapy Followed by Cystectomy: a Single-Center Experience

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Indian Journal of Surgical Oncology Aims and scope Submit manuscript

Abstract

Nearly 50% of patients with muscle-invasive bladder cancer treated with cystectomy alone will progress to metastatic disease. Surgery alone is not a sufficient therapy in a large number of patients with invasive bladder cancer. Systemic therapy with cisplatin-based chemotherapy has been shown to provide response rates in several bladder cancer studies. There have been multiple randomized controlled studies undertaken to define further the effectiveness of neoadjuvant cisplatin-based chemotherapy in advance of cystectomy. In this study, we have retrospectively reviewed our series of patients who underwent neoadjuvant chemotherapy followed by radical cystectomy for muscle-invasive disease. Between Jan 2005 and Dec 2019, 72 patients underwent radical cystectomy following neoadjuvant chemotherapy over a 15-year period. The data was retrospectively collected and analyzed. The median age was 59.84 ± 8.967 years (range, 43 to 74), and the ratio of male to female patients was 5:1. Of the 72 patients, 14 (19.44%) completed all the three cycles, 52 (72.22%) completed at least two cycles, and the remaining 6 (8.33%) completed only one cycle of neoadjuvant chemotherapy. A total of 36 (50%) patients died during the follow-up period. The mean and median survival of the patients was 84.85 ± 4.25 months and 91.0 ± 5.83 months respectively. Neoadjuvant MVAC should be offered to patients with locally advanced bladder cancer and who are candidates for radical cystectomy. It is safe and effective in patients with adequate renal function. The patients need to be carefully monitored for chemotherapy-induced toxic effects, and appropriate intervention is necessary in the event of severe adverse effects.

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Authors and Affiliations

  1. Department of Urology, JN Medical College, KLE Academy of Higher Education & Research (Deemed-To-Be-University), JNMC Campus, Nehru Nagar, Belagavi, 590010, India

    R. B. Nerli, Shridhar C. Ghagane, Rangrez Shadab, Shivagouda Patil & Amit Mungarwadi

  2. Department of Urology, KLES Kidney Foundation, KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Nehru Nagar, Belagavi, 590010, India

    R. B. Nerli, Shridhar C. Ghagane & Neeraj S. Dixit

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  1. R. B. Nerli
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  2. Shridhar C. Ghagane
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  3. Rangrez Shadab
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  4. Shivagouda Patil
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  5. Amit Mungarwadi
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  6. Neeraj S. Dixit
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Correspondence to R. B. Nerli.

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Nerli, R.B., Ghagane, S.C., Shadab, R. et al. Neoadjuvant Chemotherapy Followed by Cystectomy: a Single-Center Experience. Indian J Surg Oncol 14, 481–486 (2023). https://doi.org/10.1007/s13193-021-01386-6

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  • DOI: https://doi.org/10.1007/s13193-021-01386-6

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