Abstract | OBJECTIVES: METHODS: Sixty-seven patients with lymph node positive bladder cancer (26 pN1 and 41 pN2) who underwent radical cystectomy between April 1995 and April 2005 were reviewed. Combined adjuvant chemotherapy ( gemcitabine and cisplatin in most patients) was given to 35 patients (52%), but declined by 32 (48%). The two groups were similar in performance status, postoperative complication rate, and N stage but deferring patients were on average 5 years older and had a more advanced T stage. Study primary endpoint was overall survival (OS). RESULTS:
Adjuvant chemotherapy was well tolerated and 28/35 patients (80%) completed all 4 cycles. Median OS of patients given adjuvant chemotherapy was 48 months compared with 8 months for declining patients (hazard ratio 0.13, 95% CI 0.04-0.4, P < 0.0001). Multivariate age adjusted analysis showed that adjuvant chemotherapy was an independent factor affecting OS (hazard ratio 0.2, P < 0.0001). CONCLUSION:
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Authors | Ofer N Gofrit, Walter M Stadler, Kevin C Zorn, Shang Lin, Josephine Silvestre, Arieh L Shalhav, Gregory P Zagaja, Gary D Steinberg |
Journal | Urologic oncology
(Urol Oncol)
2009 Mar-Apr
Vol. 27
Issue 2
Pg. 160-4
ISSN: 1078-1439 [Print] United States |
PMID | 18440835
(Publication Type: Clinical Trial, Journal Article)
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Topics |
- Aged
- Aged, 80 and over
- Chemotherapy, Adjuvant
(methods)
- Female
- Humans
- Lymphatic Metastasis
- Male
- Middle Aged
- Multivariate Analysis
- Proportional Hazards Models
- Retrospective Studies
- Risk
- Treatment Outcome
- Urinary Bladder Neoplasms
(drug therapy, pathology, surgery)
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