Moschini M, et al. - Herein, authors contemplated the role of adjuvant chemotherapy in clinical node metastases bladder cancer (cN+BCa) patients treated with radical cystectomy (RC) and pelvic lymph node dissection (PLND) without neoadjuvant chemotherapy (NAC). It was determined that cN+ patients treated with RC exhibited good survival outcomes. An increase was achieved in the survival expectancies through the use of adjuvant chemotherapy (ACT), particularly in patients with pathological node disease.

Methods

• Researchers examined 192 patients with BCa and cN+.
• Enrollees were treated with RC and PLND without NAC between 2001 and 2013.
• In order to evaluate the consequence of adjuvant chemotherapy (ACT) on recurrence, cancer-specific mortality (CSM) and overall mortality (OM) after surgery, experts used the Kaplan-Meier analyses and Cox regression analyses.

Results

• Researchers detected 99 patients (51.6%) without node metastases at RC, while 18 (9.4%), 58 (30.2%) and 17 (8.9%) patients were found pN1, pN2 and pN3, respectively.
• In cN+ patients with a median follow-up of 48 months, 5-year recurrence, CSM and OM of 55, 53 and 51%, were recorded respectively.
• Herein, treatment with adjuvant chemotherapy was given for 36 (18.8%) patients.
• ACT exhibited a connection with improved overall survival [Hazard ratio (HR): 0.42, confidence interval (CI) 0.20-0.86, p=0.02) in pN+ subgroup only in the univariable analyses.
• The yielded data was ascertained in the multivariable analyses, which disclosed a correlation between ACT with improved CSS (HR: 0.45, CI 0.21-0.89, p=0.03) and OS (HR: 0.37, CI 0.17-0.81, p=0.01).