ArticleWorld journal of urology2025
Real-world impact of cisplatin-based neoadjuvant chemotherapy on bladder cancer survival: a 20-year study.
Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Perioperative outcomes following open radical cystectomy in the setting of locally advanced bladder cancer.International urology and nephrology · 2026Observational
- Years of Life Lost in Patients with Muscle-Invasive and Metastatic Bladder Cancer.Annals of surgical oncology · 2026Article
- Risk-Adapted Use of Adjuvant Systemic Therapy After Nephrectomy for Renal Cell Carcinoma: A Population-Based Study in the Post-approval Era.Annals of surgical 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
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58 authors.
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Abstract
backgroundCisplatin-based neoadjuvant chemotherapy (NAC) is the standard of care for cT2-4aN0M0 bladder cancer (BCa) patients candidates for radical cystectomy (RC). This study examines changes in NAC administration over time and its impact on survival within a large, real-world multicenter cohort.
methodsOur analysis included cT2-4aN0M0 BCa patients from 23 tertiary referral centers who underwent RC and pelvic lymph-node dissection with or without NAC administration between 2004 and 2024. The estimated annual percentage change (EAPC) was used to analyze the temporal trend of NAC administration and pathological complete response rates (pT0) over time. Subsequently, we relied on 1:1 propensity score matching (PSM) for age, sex, cT stage, Charlson Comorbidity Index (CCI), and smoking habit. Multivariable logistic regression (MLR) model addressed the association of pT0 and NAC exposure. Survival analyses consisted of Kaplan-Meier plots (KM) and multivariable Cox regression models (MCR) addressing cancer-specific mortality (CSM) and overall mortality (OM) according to NAC exposure.
resultsOverall, 3,138 patients were identified. Of these, 859 (27%) received NAC. NAC implementation increased substantially from 2004 to 2024 (EAPC: + 9.2%, p < 0.001), as well as pT0 rates (EAPC: + 7.6, p < 0.001). After 1:1 PSM (847 NAC + vs. 847 NAC-), MLR showed NAC as the strongest predictor of pT0 (OR: 2.89, p < 0.001). KM estimated 5-year CSM and OM rates of 22.5% versus 31.3% and 23.6 versus 34.5% in NAC + versus NAC-, respectively.At MCR, NAC exposure was associated with lower CSM (HR: 0.90, p = 0.01) and OM (HR:0.85, p = 0.001) rates relative to their unexposed counterparts.
conclusionsThe current study demonstrated a significant increase in NAC administration over time, accompanied by higher rates of pT0 as well as improved survival among NAC-treated patients. The major limitation is represented by the retrospective nature of the study.
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