800P - Muscle invasive urinary bladder cancer: response to neoadjuvant chemotherapy is predictor of improved progression free survival

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Anti-Cancer Agents & Biologic Therapy
Urothelial Cancers
Presenter Bivas Biswas
Authors B. Biswas1, R.K. Sahoo2, L. Kumar2, B.K. Mohanti3, A. Seth4
  • 1Dept. Of Medical Oncology, All India Institute of Medical Sciences (AIIMS) Institute Rotary Cancer Hospital, 110029 - New Delhi/IN
  • 2Medical Oncology, AIIMS, New Delhi/IN
  • 3Radiation Oncology, AIIMS, New Delhi/IN
  • 4Urology, AIIMS, New Delhi/IN

Abstract

Purpose

To evaluate the prognostic factors and outcome of patients with muscle invasive carcinoma of urinary bladder.

Study design

Retrospective analysis.

Method

Between January 2005 to August 2011, 270 patients of carcinoma of urinary bladder were registered; 218 patients were evaluable for analysis.

Results

Median age of study population was 58 years (range: 24 to 85 years) with male: female ratio of 8.5:1 and median duration of symptoms was 5 months (range: 1–40 months). Hematuria was most common presenting symptom (92%) followed by dysuria (25%). Transitional cell carcinoma was the most common histology (93%) followed by adenocarcinoma (4%) and squamous cell carcinoma (3%). Tumor was high grade in 79% of patients and muscle invasion was present in 91%. 28 patients (13%) had metastasis at presentation with bone being the commonest site. TNM (AJCC 7th) staging revealed stage IV: 50%, stage III: 16%, stage II: 25%. 42 patients (19%) received gemcitabine/platinum based neoadjuvant chemotherapy (NACT) with overall response rate of 57% (complete remission rate-33%). 110 patients underwent radical cystectomy and 54 out of 110 patients received adjuvant therapy. At a median follow up of 23 months median progression free survival (PFS) is 26.3 months (95% CI: 5.1–98 months) for the whole cohort and 18 months (95% CI: 5–40 months) in the metastatic group. Median PFS is 35.5 months (95% CI: 5–73 months) and 16.7 months (95% CI: 3–30 months) in chemoresponders and non-responders respectively. On analysis of prognostic factors response to NACT was strong predictor of PFS (p = 0.002). Age (p = 0.7), histology (p = 0.9), grade (p = 0.4) or stage (II/III vs IV, p = 0.24) did not affect the PFS.

Conclusion

For locally advanced carcinoma of urinary bladder, chemosensitivity is an important determinant of outcome.

Disclosure

All authors have declared no conflicts of interest.