Presentation Authors: Do Kyung Kim*, Joo Yong Lee, seoul, Korea, Republic of, Jae Hung Jung, wonju, Korea, Republic of, Yoon Soo Hah, Kyo Chul Koo, Kwang Suk Lee, Byung Ha Chung, Kang Su Cho, seoul, Korea, Republic of
Introduction: We aimed to evaluate the effects of adjuvant chemotherapy (ACH) on survival outcomes in patients with muscle-invasive bladder cancer (MIBC) treated with radical cystectomy (RC). A subgroup analysis was also performed to examine effects in patients with locally advanced MIBC.
Methods: A comprehensive literature search was performed in the PubMed, Embase, and Cochrane library databases for all articles published until February. The systematic review and meta-analysis was performed by pooling the randomized controlled trials (RCTs) that compared patients who received ACH after RC with those who underwent cystectomy alone.
Results: Eight RCTs with a total of 979 patients were selected for the analysis. These eight trials included patients with MIBC. The pooled hazard ratios (HRs) for progression-free survival (PFS) and overall survival (OS) were 0.61 (95% confidence interval [CI], 0.46â€“0.80; p = 0.0005) and 0.72 (95% CI, 0.55â€“0.94; p = 0.02), respectively. Four of the eight trials included patients with locally advanced MIBC (pT3-4 or pN+, or both); the pooled HRs for PFS and OS were 0.48 (95% CI, 0.39â€“0.60; p < 0.00001), and 0.63 (95% CI, 0.48â€“0.83; p = 0.0009), respectively. The absolute increases in PFS and OS for MIBC were 10% and 5%, respectively. The absolute increases in PFS and OS (17% and 10%, respectively) for locally advanced MIBC were greater compared with the absolute increases for MIBC.
Conclusions: ACH following RC may improve the survival outcomes of MIBC patients. The beneficial effect of ACH might be more pronounced in patients with locally advanced MIBC.