Kas-İnvaziv mesane kanserinde neoadjuvan ve adjuvan kemoterapinin sağkalım üzerine etkinliği: Çok merkezli çalışma

Year 2025, Volume: 16 Issue: 1, 123 - 130, 25.03.2025

Nargiz Majidova , Ahmet Emin Öztürk , Rumeysa Çolak , Özge Yalıcı , Mehmet Cihan İçli , Barış Köksal , Murat Arcagök , Sevdenur Taşkın , Yaprak Caglar Ali Kaan Güren , Erkam Kocaaslan , Pınar Erel , Yeşim Ağyol , Nadiye Sever , Abdussamet Çelebi , Rukiye Arıkan , Selver Işık , Vedat Bayoğlu , Osman Köstek , Erdoğan Selçuk Şeber , Zuhat Urakçı , Murat Sarı

https://doi.org/10.18663/tjcl.1575691

Abstract

Amaç: Kasa invaze mesane kanserinin tedavisinde yüksek metastaz riski nedeniyle sistemik tedavi önerilmektedir. Neoadjuvan veya adjuvan tedaviyi karşılaştıran yeterli çalışma olmaması nedeniyle bu çalışmada amacımız lokal ileri evre mesane kanserinde neoadjuvan veya adjuvan tedavi alan hastaların tedavi etkinliğini karşılaştırmaktır.
Gereç ve Yöntemler: Radikal sistektomi yapılan ve perioperatif kemoterapi alan 6 merkezden 107 mesane kanseri hastası retrospektif olarak çalışmaya dahil edildi. Hastalar 2 kategoriye ayrıldı: (i) neoadjuvan kemoterapi (n=54) ve (ii) adjuvan kemoterapi (n=53). Ortanca takip süresi 31.6 aydı (%95CI 21.8-41.4). 30. ay hastalıksız sağkalım oranı (HSO) tüm grupta %58.9, neoadjuvanda %56.3 ve adjuvanda %61.5 idi. Neoadjuvan tedavi sonrası 30.ay HSS evrelemeye göre Sonuç: Neoadjuvan ve adjuvan kemoterapi, kas-invaziv mesane kanseri tedavisinde sağkalımı önemli ölçüde etkileyen yaklaşımlardır. Patolojik tam yanıt ve sisplatin bazlı rejimler, daha iyi sağkalım sonuçları ile ilişkilidir. Bu bulgular, tedavi planlamasında patolojik tam yanıtın ve rejim seçiminin önemini vurgulamaktadır ve tedavi kararı multidispliner olarak verilmelidir.

Keywords

mesane kanseri, neoadjuvan kemoterapi, radikal sistektomi, adjuvan kemoterapi, sağkalım sonuçları

Effects of neoadjuvant and adjuvant chemotherapy on survival in muscle-invasive bladder cancer: A multicenter study

Abstract

Aim: Muscle-invasive bladder cancer requires systemic treatment due to its high risk of metastasis. However, studies comparing neoadjuvant and adjuvant therapy regimens are currently limited. Our goal in this study was to compare the treatment efficacy of patients receiving neoadjuvant or adjuvant treatment in locally advanced bladder cancer.
Material and Methods: We retrospectively included 107 bladder cancer patients from 6 centres who underwent radical cystectomy and received perioperative chemotherapy. Patients were divided into 2 categories: (i) neoadjuvant chemotherapy (n=54) and (ii) adjuvant chemotherapy (n=53).
Results: Median follow-up was 31.6 months (95%CI 21.8-41.4). 30-month disease-free survival (DFS) was 58.9% in the whole group, 56.3% in neoadjuvant and 61.5% in adjuvant. 30-month DFS after neoadjuvant treatment was 70.1% in Conclusion: In patients with locally advanced bladder cancer who show a pathologically complete response to neoadjuvant chemotherapy, it is important to be evaluated in a multidisciplinary consultation in order to give cisplatin- based treatment before surgery since it has a significant contribution in terms of both DFS and OS.

Keywords

Bladder cancer, neoadjuvant chemotherapy, radical cystectomy, adjuvant chemotherapy, outcome analysis

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