Abstract | OBJECTIVE: To determine the predictive value of the radiological response rate assessed by serial pelvic computed tomography scans for pathological response to neoadjuvant chemotherapy and clinical outcomes after radical cystectomy in bladder urothelial cancer patients. METHODS: RESULTS: The pathological complete response rate was 25% (n = 15) and the median (range) radiological response rate was 0.58 (0.00-1.00). The radiological response rate was significantly associated with ≤pT1. Patients with pathological downstaging to ≤pTa/is or pT1, compared with those with pT2≤ tumor, had significantly better post- radical cystectomy recurrence-free survival (2-year survival 92.0, 88.9, 36.8%, respectively, P < 0.0001), disease-specific survival (2-year survival 95.8, 88.9, 47.3%, respectively, P < 0.0001) and overall survival (2-year survival 91.7, 88.9, 40.1%, respectively, P < 0.0001). Patients with a higher radiological response rate (≥0.57) had significantly better post- radical cystectomy recurrence-free survival (2-year survival 89.7 vs. 48.1%, P = 0.0011), disease-specific survival (2-year survival 93.2 vs. 48.2%, P < 0.0001) and overall survival (2-year survival 90.0 vs. 39.0%, P < 0.0001). Multivariate analyses using the Cox proportional hazard model revealed that the radiological response rate was an independent predictor for favorable pT stage and recurrence-free survival. CONCLUSION: The radiological response rate determined by pretreatment and post- chemotherapy computed tomography scans predicts the pathological outcome and post- radical cystectomy prognosis, which is clinically relevant and useful for patient counselling and decision-making.
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Authors | Tomohiro Fukui, Yoshiyuki Matsui, Shigeaki Umeoka, Takahiro Inoue, Tomomi Kamba, Kaori Togashi, Osamu Ogawa, Takashi Kobayashi |
Journal | Japanese journal of clinical oncology
(Jpn J Clin Oncol)
Vol. 46
Issue 6
Pg. 560-567
(06 2016)
ISSN: 1465-3621 [Electronic] England |
PMID | 26962244
(Publication Type: Journal Article)
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Copyright | © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: [email protected]. |