Patterns of chemotherapy use in muscle-invasive bladder cancer in a tertiary centre

Kylie Yen-Yi Lim^1,2, Kevin Chu¹, Nieroshan Rajarubendra¹, ames Huang¹, David Pook³, Paul Manohar¹, Matthew Harper¹, Scott Donnellan¹, Weranja Ranasinghe^1,4

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¹ Department of Urology, Monash Health, Casey, VIC, Australia

² School of Clinical Sciences, Monash University, Clayton, VIC, Australia

³ Department of Oncology, Monash Health, Clayton, VIC, Australia

⁴ Department of Anatomy and Developmental Biology, Monash University, Clayton, VIC, Australia

Bladder 2023 , 10(1), 1;

© 2023 by the author. Licensee POL Scientific, USA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

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Abstract

Objectives: Although neoadjuvant chemotherapy (NAC) has been demonstrated to have significant benefits to survival in patients with muscle-invasive bladder cancer (MIBC), the current utilization of NAC in Australia is unknown. The aim of this study was to evaluate the patterns of neoadjuvant and adjuvant chemotherapy (AC) use in patients undergoing cystectomy for MIBC at a large tertiary institution in Australia.

Methods: A retrospective study was conducted using data of patients who underwent a radical cystectomy (RC) at a high-volume centre for MIBC between 2011 and 2021.

Results: Of 69 patients who had a cystectomy for ≥ pT2 bladder cancer, 73.9% were eligible for NAC. However, of those eligible, only five patients received NAC (9.8%). Of the total patients who were eligible for AC, only 44.4% received postoperative chemotherapy. Common reasons for the lack of uptake were due to patients being unfit or declining treatment. There was no difference in progression-free survival or overall survival in those who received NAC and AC.

Conclusions: The majority of patients undergoing RC for MIBC received AC compared to NAC, reflecting the real-world challenge of NAC uptake. This highlights the need for ongoing improvements in selection and usage of NAC and less reliance of AC utilization post RC.

Keywords

Adjuvant chemotherapy

chemotherapy

cystectomy

neoadjuvant therapy

muscle-invasive bladder cancer

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