Adjuvant cisplatin-based combined chemotherapy for lymph node (LN)-positive urothelial carcinoma of the bladder (UCB) after radical cystectomy (RC): a retrospective international study of >1500 patients.

摘要: Objective To compare outcomes of patients with lymph node (LN)-positive urothelial carcinoma the bladder (UCB) treated or without cisplatin-based combined adjuvant chemotherapy (AC) after radical cystectomy (RC). Patients and Methods We retrospectively analysed 1523 LN-positive UCB, who underwent RC bilateral pelvic LN dissection. All had no evidence disease RC. AC was administered within 3 months. Competing-risks models were applied to UCB-related mortality. Results Of patients, 874 (57.4%) received AC. The cumulative 1-, 2- 5-year mortality rates for all 16%, 36% 56%, respectively. Administration associated an 18% relative reduction in risk death (subhazard ratio 0.82, P = 0.005). absolute 3.5% at 5 years. positive effect detectable aged ≤70 years, women, pT3–4 disease, those a higher density lymphovascular invasion. This study is limited by its retrospective non-randomised design, selection bias, absence central pathological review lack standardisation dissection protocols. Conclusion AC seems reduce UCB Younger women high-risk features such as invasion appear benefit most. Appropriately powered prospective randomised trials are necessary confirm these findings.