ArticleActa oncologica (Stockholm, Sweden)2025
Real-world data on utilization of neoadjuvant chemotherapy for muscle invasive bladder cancer: impact on surgical complications and oncological efficacy.
Article in Acta oncologica (Stockholm, Sweden), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Perioperative therapy in muscle-invasive bladder cancer: real-world evidence from the MINOTAURO study.ESMO real world data and digital oncology · 2026Article
- Clinical and pathological predictors of early recurrence after neoadjuvant cisplatin gemcitabine in muscle invasive bladder cancer in the RealBLADDER study.Scientific reports · 2026Observational
- Characteristics, Treatment Patterns, and Outcomes of Patients with Muscle-Invasive Bladder Cancer Undergoing Radical Cystectomy: A Retrospective Analysis of Health Insurance Claims Data in Germany.Oncology and therapy · 2026Article
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6 authors.
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Abstract
background and purposeRecommended treatment of urothelial muscle-invasive bladder cancer (MIBC) is cisplatin-based neoadjuvant chemotherapy (NAC) followed by cystectomy, but there are challenges with low utilization of NAC. We aimed to evaluate the utilization of NAC, perioperative complications and oncological efficacy in a real-world setting. PATIENTS AND
methodsAll patients operated with radical cystectomy at the University Hospital of North Norway during 2011-2021 for MIBC were included. NAC consisted of three cycles of dose-dense methotrexate, vinblastine, doxorubicin and cisplatin (ddMVAC) every second week. Complications after cystectomy (Clavien-Dindo ≥ grade 3 within 30 days), histopathologic NAC response, cancer recurrence, relapse-free survival (RFS), overall survival (OS) and cause of death were reported.
resultsWe included 124 patients, median observation time of 4 years. Fifty-nine patients (48%) received NAC. Most common causes for not receiving NAC were age ≥ 75 years (n = 38; 31%), cardiovascular disease (n = 7; 5.6%), and reduced kidney function (n = 6; 4.8%). Overall 34 patients (27%) had a ≥ grade 3 complication. The 5-year actuarial OS rate was higher among patients treated with NAC than those without NAC (67% vs. 45%, p = 0.02). Among NAC-treated patients, 29 (49%) were downstaged to non-muscle invasive stage (≤pT1), and the 5-year actuarial RFS and OS were higher among patients with ≤pT1 in the post-cystectomy specimen than those with ≥ pT2 (92% vs. 35%, and 94% vs. 39%, both p < 0.001).
interpretationThe utilization of NAC was high in this real-world setting. Treatment with ddMVAC with achieved downstaging to ≤pT1 was associated with considerably improved RFS and OS.
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