Radical Cystectomy Added to Chemotherapy Ups Survival in cN1 Bladder Cancer

WASHINGTON, DC—Patients with bladder cancer and limited regional lymph node involvement may benefit from undergoing radical cystectomy (RC) in addition to chemotherapy, investigators reported at the Society of Urologic Oncology’s 24th Annual Meeting.

Investigators studied 475 US veterans with nonmetastatic bladder cancer and clinical evidence of regional lymph node involvement. Of these, 170 underwent RC with peri-operative chemotherapy and 305 did not. After propensity score matching, 156 patients in each group were included in the study.

On multivariable analysis, RC was significantly associated with a 35% lower risk for death overall, Amirali Salmasi, MD, of the UC San Diego School of Medicine in La Jolla, and colleagues reported in a poster presentation. In a subset analysis, the investigators observed a survival benefit of RC only in patients with cN1 disease. In these patients, RC was significantly associated with a 46% lower risk for death. The investigators observed no overall survival benefit among patients with cN2/N3 bladder cancer.

In addition, RC after neoadjuvant chemotherapy was significantly associated with a 37% reduction in mortality risk in a sensitivity analysis.

Among the 156 patients in the RC group, 84 (54%) and 72 (46%) received neoadjuvant and adjuvant chemotherapy, respectively.

“As part of multimodal treatment, RC improves overall survival in a subset of patients with clinically regional lymph node metastasis, Dr Salmasi’s team concluded.

Reference

Salmasi A, Meagher MF, Morgan K, Deshler L, Rose B, Stewart TF. Role of radical cystectomy in management of bladder cancer with clinical evidence of regional lymph node involvement at US Veterans Health Administration facilities. Presented at: SUO 2023; November 28-December 1, Washington, DC. Poster 55.

This article originally appeared on Renal and Urology News