Neoadjuvant chemotherapy with radical cystectomy versus radical cystectomy alone for muscle-invasive bladder cancer

Authors

Ahmed M. El-Zeiny, Menoufia UniversityFollow
Atef A. Badawy, Menoufia University
Baher M. Salman, Menoufia University
Mohamed A. Elsayed, Menoufia University
Sultan M. Sultan, Menoufia University

Subject Area

Urology

Article Type

Original Study

Abstract

Background Radical cystectomy (RC) is the gold standard in the treatment of muscle-invasive bladder cancer. Objectives To compare the pathologic response and perioperative morbidity of neoadjuvant chemotherapy (NAC) with cystectomy against RC alone as a treatment for muscle-invasive bladder cancer. Patients and methods This randomized controlled clinical trial took place between December 2020 and December 2021. The study enrolled 40 patients with muscle-invasive transitional cell carcinoma of the urinary bladder. Patients were randomized into two treatment groups: group I (20 patients) was treated with RC alone, and group II (20 patients) received three cycles of NAC with cystectomy. Results Of 20 patients of group II, only 16 patients completed NAC. Pretreatment patient criteria were comparable between both groups. Downstaging in postcystectomy specimen was significantly higher in group II than group I (pT0 12.5 vs. 0% and pT1 12.5 vs. 0%, respectively). There was no significant difference in postoperative complications between patients undergoing NAC plus RC and RC alone, with an overall complication rate of 68.8 and 66.7% in groups II and I, respectively. Conclusion NAC with RC is helpful in downstaging of the bladder cancers without increasing the perioperative morbidity related to RC.

Recommended Citation

El-Zeiny, Ahmed M.; Badawy, Atef A.; Salman, Baher M.; Elsayed, Mohamed A.; and Sultan, Sultan M. (2023) "Neoadjuvant chemotherapy with radical cystectomy versus radical cystectomy alone for muscle-invasive bladder cancer," Menoufia Medical Journal: Vol. 35: Iss. 4, Article 71.
DOI: https://doi.org/10.4103/mmj.mmj_185_22