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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Neoadjuvant Chemotherapy is Not Associated with Adverse Perioperative Outcomes after Robot-Assisted Radical Cystectomy: A Case for Increased Use from the IRCC
Journal of Urology, Volume 203, No. 1, Year 2020
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Description
Purpose:We sought to determine the trend of neoadjuvant chemotherapy use for nonmetastatic muscle invasive urothelial bladder cancer and whether it is associated with adverse perioperative morbidity after robot-assisted radical cystectomy.Materials and Methods:We retrospectively reviewed the IRCC (International Robotic Cystectomy Consortium) database between 2006 and 2017. After excluding patients with nonmuscle invasive bladder cancer the patients were divided into 2 groups, including those who did vs did not receive neoadjuvant chemotherapy. Data were reviewed for demographics, preoperative, operative and 90-day perioperative outcomes. We used the Cochran-Armitage trend test to assess trends of neoadjuvant chemotherapy associations with high grade and overall complications with time. Multivariate stepwise regression analyses were done to determine whether neoadjuvant chemotherapy was associated with prolonged operative time, 90-day postoperative complications, readmissions, reoperations and mortality after robot-assisted radical cystectomy.Results:A total of 298 patients (26%) received neoadjuvant chemotherapy. These patients were younger (age 67 vs 69 years, p=0.01) and more frequently had an ASA™ (American Society of Anesthesiologists™) score of 3 or greater (62% vs 55%, p=0.02) and pathological T3 stage or greater disease (28% vs 22%, p=0.04). The use of neoadjuvant chemotherapy increased significantly from 10% in 2006 to 2007 to 42% in 2016 to 2017 (p <0.01). On multivariate analysis neoadjuvant chemotherapy was not significantly associated with prolonged operative time, hospital stay, 90-day postoperative complications, reoperation or mortality. Neoadjuvant chemotherapy was associated with 90-day readmissions after robot-assisted radical cystectomy (OR 5.90, 95% CI 3.30-10.90, p <0.01).Conclusions:Neoadjuvant chemotherapy utilization has significantly increased in the last decade. It was not associated with perioperative surgical morbidity after robot-assisted radical cystectomy. Copyright © 2020 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION AND RESEARCH, INC.
Authors & Co-Authors
Aldhaam, Naif A.
United States, Buffalo
Roswell Park Cancer Institute
Elsayed, Ahmed S.
United States, Buffalo
Roswell Park Cancer Institute
Jing, Zhe
United States, Buffalo
Roswell Park Cancer Institute
Richstone, Lee
United States, New Hyde Park
Arthur Smith Institute for Urology
Wagner, Andrew Aurel
United States, Boston
Beth Israel Deaconess Medical Center
Rha, Koon-ho
Unknown Affiliation
Yuh, Bertram E.
United States, Duarte
City of Hope National Med Center
Khan, Muhammed Shamim
United Kingdom, London
Guy's Hospital
Menon, Mani M.
United States, Detroit
Henry Ford Health System
Rouprêt, Morgan
France, Paris
Hôpital Universitaire Pitié Salpêtrière
Hosseini, Abolfazl
Sweden, Stockholm
Karolinska Institutet
Wiklund, Peter N.
Sweden, Stockholm
Karolinska Institutet
Gaboardi, Franco
Unknown Affiliation
Maatman, Thomas J.
Unknown Affiliation
Mottrie, Alexandre Marie
Belgium, Aalst
Onze Lieve Vrouw Hospital
Wijburg, Carl J.
Netherlands, Arnhem
Rijnstate Hospital
Stöckle, Michael
Germany, Homburg
Universitätsklinikum Des Saarlandes Medizinische Fakultät Der Universität Des Saarlandes
Hemal, Ash Kumar
United States, Winston Salem
Wake Forest Baptist Health
Kim, Eric H.
United States, St. Louis
Washington University in St. Louis
Kaouk, Jihad H.
United States, Cleveland
Cleveland Clinic Foundation
Hussein, Ahmed Aly
United States, Buffalo
Roswell Park Cancer Institute
Guru, Khurshid Ahad
United States, Buffalo
Roswell Park Cancer Institute
Statistics
Citations: 24
Authors: 22
Affiliations: 16
Identifiers
Doi:
10.1097/JU.0000000000000445
ISSN:
00225347
Research Areas
Cancer
Health System And Policy