Abstract | BACKGROUND: METHODS: Diagnostic tumour samples were available from 230 BC2001 patients. Tumour necrosis was scored on whole-tissue sections as absent or present, and its predictive and prognostic significance explored using Cox proportional hazards models. Survival estimates were obtained by Kaplan-Meier methods. RESULTS: Tumour necrosis was present in 88/230 (38%) samples. Two-year LRC estimates were 71% (95% CI 61-79%) for the MMC/5-FU chemoradiotherapy group and 49% (95% CI 38-59%) for the radiotherapy alone group. When analysed by tumour necrosis status, the adjusted hazard ratios (HR) for MMC/5-FU vs. no chemotherapy were 0.46 (95% CI: 0.12-0.99; P=0.05, necrosis present) and 0.55 (95% CI: 0.31-0.98; P=0.04, necrosis absent). Multivariable analysis of prognosis for LRC by the presence vs. absence of necrosis yielded a HR=0.89 (95% CI 0.55-1.44, P=0.65). There was no significant association for necrosis as a predictive or prognostic factor with respect to overall survival. CONCLUSIONS: Tumour necrosis was neither predictive nor prognostic, and therefore MMC/5-FU is an appropriate radiotherapy-sensitising treatment in MIBC independent of necrosis status.
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Authors | Ananya Choudhury, Catharine M West, Nuria Porta, Emma Hall, Helen Denley, Carey Hendron, Rebecca Lewis, Syed A Hussain, Robert Huddart, Nicholas James |
Journal | British journal of cancer
(Br J Cancer)
Vol. 116
Issue 5
Pg. 649-657
(Feb 28 2017)
ISSN: 1532-1827 [Electronic] England |
PMID | 28125821
(Publication Type: Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial)
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Chemical References |
- TNF protein, human
- Tumor Necrosis Factor-alpha
- Mitomycin
- Fluorouracil
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Topics |
- Adult
- Aged
- Chemoradiotherapy
(methods)
- Female
- Fluorouracil
(administration & dosage, therapeutic use)
- Humans
- Male
- Middle Aged
- Mitomycin
(administration & dosage, therapeutic use)
- Neoplasm Invasiveness
- Predictive Value of Tests
- Prognosis
- Survival Analysis
- Treatment Outcome
- Tumor Necrosis Factor-alpha
(metabolism)
- Urinary Bladder Neoplasms
(metabolism, pathology, therapy)
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