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The long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy combined with radical cystectomy vs radical cystectomy alone for bladder cancer: A propensity-score matching study

BMC Urology Nov 20, 2019

Wahafu W, Liu S, Xu W, et al. - Researchers conducted this retrospective review to compare the long-term effectiveness of one-shot neoadjuvant intra-arterial chemotherapy (IAC) vs no IAC (NIAC) before radical cystectomy (RC) for bladder cancer. The sample consisted of patients who had either one-shot IAC or NIAC before RC between October 2006 and November 2015. To estimate survival outcomes, a multivariable Cox proportional hazard model was used. According to results, 26 patients were treated using IAC before RC, and 123 NIAC patients also had RC. After matching, no significant difference was found between groups in baseline features, perioperative variables, complication outcomes or tumor characteristics. Pathological tumor stages exhibited a significant reduction in the IAC group compared with clinical tumor stages. No significant difference was found in overall survival (OS) or cancer-specific survival (CSS) between the groups. Among all individuals, BMI significantly affected OS, and positive lymph nodes significantly affected both OS and CSS. One-shot neoadjuvant IAC before RC demonstrates tolerability and safety and gives a major advantage in pathological downstaging but not in OS or CSS. Further research of neoadjuvant combination therapeutic strategies with RC is required.
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