Observational studyInternational journal of urology : official journal of the Japanese Urological Association2026
Perioperative Systemic Treatment Patterns and Postoperative Mortality Among Patients With Muscle-Invasive Bladder Cancer Undergoing Radical Cystectomy in Japan: WAKKA-MIBC Study.
Observational study in International journal of urology : official journal of the Japanese Urological Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Editorial Comment to "Perioperative Systemic Treatment Patterns and Postoperative Mortality Among Patients With Muscle-Invasive Bladder Cancer Undergoing Radical Cystectomy in Japan: WAKKA-MIBC Study".International journal of urology : official journal of the Japanese Urological Association · 2026Article
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Authors and funding
7 authors.
Funding
Abstract
objectivesTo characterize the temporal changes in perioperative systemic treatment patterns and postoperative mortality among Japanese patients with stage II-III muscle-invasive bladder cancer (MIBC) undergoing radical cystectomy (RC) from 2013 to 2024.
methodsThis retrospective observational cohort study assessed neoadjuvant chemotherapy (NAC) and adjuvant therapy (AT) relative to RC. Treatment patterns (NAC + RC + AT, NAC + RC, RC + AT, and RC alone), NAC regimen selection, and 30- and 90-day postoperative mortality were evaluated across three periods (2013-2017, 2018-2021, and 2022-2024). Analyses were descriptive.
resultsAmong 5 208 patients, the use of NAC + RC increased from 31.4% in 2013-2017 to 50.4% in 2022-2024, and the use of NAC + RC + AT increased from 8.7% to 22.4%. RC alone decreased from 46.3% to 21.4%. Reduced-dose gemcitabine + cisplatin (GC) and gemcitabine + carboplatin were frequently used and remained common throughout the study period. In 2022-2024, 18.8% of patients received adjuvant nivolumab; most had received NAC beforehand (242/270). The 30- and 90-day mortality remained low regardless of the increase in NAC use (30-day: ≤ 0.2% with NAC vs. ≤ 1.5% without; 90-day: ≤ 1.4% with NAC vs. ≤ 3.3% without).
conclusionsPerioperative systemic therapy for MIBC in Japan has intensified over the past decade, with increased adoption of NAC and adjuvant nivolumab. Dose-modified GC and carboplatin-based regimens have remained commonly used throughout the study period. Even with increased NAC use, postoperative mortality has remained low.
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