Evidence map›Paper›PMID 29752514›Full record

ArticleWorld journal of urology2018

Overall survival in patients with residual disease after radical cystectomy and neoadjuvant chemotherapy.

Izak Faiena, Amirali Salmasi, Neil Mendhiratta, Andrew T Lenis, Aydin Pooli, Alexandra Drakaki, Kiran Gollapudi, Jeremy Blumberg, Allan J Pantuck, Karim Chamie

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Article in World journal of urology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Izak FaienaDepartment of Urology, David Geffen School of Medicine at University of California, Los Angeles, USA. ifaiena@gmail.com.ORCID http://orcid.org/0000-0001-6095-2757
Amirali SalmasiDepartment of Urology, David Geffen School of Medicine at University of California, Los Angeles, USA.
Neil MendhirattaDepartment of Urology, David Geffen School of Medicine at University of California, Los Angeles, USA.
Andrew T LenisDepartment of Urology, David Geffen School of Medicine at University of California, Los Angeles, USA.
Aydin PooliDepartment of Urology, David Geffen School of Medicine at University of California, Los Angeles, USA.
Alexandra DrakakiDepartment of Urology, David Geffen School of Medicine at University of California, Los Angeles, USA.
Kiran GollapudiDivision of Urology, Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA.
Jeremy BlumbergDivision of Urology, Department of Surgery, Harbor-UCLA Medical Center, Torrance, CA, USA.
Allan J PantuckDepartment of Urology, David Geffen School of Medicine at University of California, Los Angeles, USA.
Karim ChamieDepartment of Urology, David Geffen School of Medicine at University of California, Los Angeles, USA.
University of California, Los Angeles · USUCLA Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeoadjuvant chemotherapy (NAC) has been shown to improve survival in patients with urothelial carcinoma (UC). However, there are a subset of patients who do not respond or progress despite systemic treatment.

methodsData from the National Cancer Database on patients who underwent a radical cystectomy (RC) with or without NAC from 2006 to 2013 were abstracted. Covariates were balanced using inverse probability weighting methods. The primary outcome of overall survival in patients with residual disease by stage was evaluated using 90-day conditional landmark analysis and Cox proportional hazards modeling. Secondary outcome of predictors of residual disease was evaluated using multivariable logistic regression analysis.

resultsA total of 20,128 patients met our inclusion criteria; 16,058 patients underwent RC only (80%) and 4070 underwent RC with NAC (20%). Patients who received NAC were younger and healthier, treated at an academic center, and presented with higher stage. NAC was associated with improved overall survival amongst patients with cT3-4aN0 (HR 0.84 95% CI 0.73-0.97; p = 0.02) and cN+ (HR 0.70, 95% CI 0.58-0.86; p = 0.001). Predictors of no residual disease were NAC (OR 0.17, 95% CI 0.14-0.21; p < 0.001) and treatment at an academic facility (OR 0.47, 95% CI 0.37-0.60; p < 0.001). Patients with cT3-4a or cN+ had increased odds of having residual UC (OR 2.01, 95% CI 1.53-2.64; p < 0.001, and OR 2.14, 95% CI 1.43-3.21; p < 0.001, respectively) compared with cT2.

conclusionIn patients with residual UC, NAC is associated with a significant survival benefit in higher stage disease only. Furthermore, those treated with NAC or at an academic center were less likely to have residual disease. Given the toxicity of NAC, more prudent patient selection for NAC is warranted and requires further study.

Indexed as

CystectomyNeoadjuvant TherapyAgedAntineoplastic AgentsCarcinoma, Transitional CellCase-Control StudiesDatabases, FactualFemaleHumansKaplan-Meier EstimateLogistic ModelsMaleMiddle AgedMultivariate AnalysisNeoplasm, ResidualNeoplasm StagingAntineoplastic AgentsNeadjuvant chemotherapyRadical cystectomyResidual diseaseUrothelial carcinoma

Identifiers

PMID29752514
OpenAlexW2801994002

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.