Objective: To analyze trends in perioperative chemotherapy and optimize use of neoadjuvant chemotherapy for bladder cancer.
Methods: From 2005-2012, 284 consecutive patients underwent robot-assisted radical cystectomy at our facility. Patients with disease ≥ T2 and nodal involvement and positive surgical margins were reviewed and considered candidates for referral to medical oncology for chemotherapy. The study was conducted in two phases: phase 1 included 242 consecutive patients between 2005 and 2011, and phase 2 analyzed the effect of changes in 42 patients during a 1-year period (2011-2012).
Results: In phase 1, 148 patients (61%) were candidates for neoadjuvant chemotherapy (NAC). Consultation for NAC was sought for 44 patients (29%), and 104 (71%) did not receive consultation. Of the 44 patients, 36% received NAC, 7% refused, 32% were recommended for immediate cystectomy, and 25% did not receive NAC for other reasons. Phase 2 was more stringent, with a multidisciplinary approach. Significant improvement in referral and NAC use was seen. About 78% vs 30% of patients were seen by medical oncology for consideration of NAC before robot-assisted radical cystectomy and 71% vs 36% received NAC compared with phase 1. The NAC utilization rate improved from 10.8% to 55% over 1 year with a diligent multidisciplinary approach. Medical comorbidities were the main reason for patients not receiving adjuvant chemotherapy (AC; 30% and 33%).
Conclusion: A multidisciplinary approach and coordination of services can help optimize the use of neoadjuvant chemotherapy for bladder cancer.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.urology.2013.07.055 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Carbonic Anhydrase IX Enzyme in Triple Negative Breast Carcinoma: Relationship With Prognostic Factors and Response to Neoadjuvant Chemotherapy.
Eur J Breast Health
January 2025
Department of General Surgery, Elazığ Fethi Sekin City Hospital, University of Health Sciences Turkey, Elazığ, Turkey.
Objective: Triple negative breast carcinoma (TNBC) is characterized by the absence of estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2 receptor expression. Carbonic anhydrase IX (CA IX) is a tumor-associated cell surface glycoprotein that is involved in adaptation to hypoxia-induced acidosis and plays a role in cancer progression. The aim of this study was to investigate CA IX expression in TNBC and its relationship with treatment effect.
View Article and Find Full Text PDFAssessment of Tumor Response to Neoadjuvant Chemotherapy in Breast Cancer Using MRI and F-FDG PET/CT.
Eur J Breast Health
January 2025
Department of Surgery, Salmaniya Medical Complex, Government Hospitals, Manama, Bahrain.
Objective: Neoadjuvant chemotherapy (NACT) has been the primary treatment method for patients with local advanced breast cancer. A pathological complete response (pCR) to therapy correlates with better overall disease prognosis. Magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) have been widely used to monitor the response to NACT in breast cancer.
View Article and Find Full Text PDFThe effect of intraoperative radiotherapy in musculoskeletal malignancy: A population study from US SEER database.
J Cancer
January 2025
Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute &Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin 300060, China.
The aim of our study was to explore the effect of IORT on survival outcome of patients with musculoskeletal malignancy. The prognostic factors of patients with IORT treatment were also identified in this study. The retrospective analysis was conducted based on the Surveillance, Epidemiology, and End Results (SEER) database spanning from 2000 to 2020.
View Article and Find Full Text PDFAnalysis of the short-term efficacy of 2 versus 3 cycles of neoadjuvant immunotherapy combined with chemotherapy in patients with esophageal squamous cell carcinoma.
J Cancer
January 2025
Department of Thoracic Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Neoadjuvant immunotherapy combined with chemotherapy has a substantial impact on locally advanced esophageal squamous cell carcinoma (LA-ESCC), but the optimal number of treatment cycles is still controversial. Patients who received 2 or 3 cycles of neoadjuvant immunotherapy combined with chemotherapy followed by esophagectomy to treat LA-ESCC were included. We compared the responses to neoadjuvant therapy, surgical outcomes, perioperative complications, and treatment-related adverse reactions in the two patient groups.
View Article and Find Full Text PDFQuantitative Histopathology Analysis Based on Label-free Multiphoton Imaging for Breast Cancer Diagnosis and Neoadjuvant Immunotherapy Response Assessment.
Int J Biol Sci
January 2025
Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Accurate diagnosis and assessment of breast cancer treatment responses are critical challenges in clinical practice, influencing patient treatment strategies and ultimately long-term prognosis. Currently, diagnosing breast cancer and evaluating the efficacy of neoadjuvant immunotherapy (NAIT) primarily rely on pathological identification of tumor cell morphology, count, and arrangement. However, when tumors are small, the tumors and tumor beds are difficult to detect; relying solely on tumor cell identification may lead to false negatives.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!