Does neo-adjuvant chemotherapy improve the negative effect of lymphovascular invasion in survival after radical cystectomy?

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dc.contributor.authorYilmaz, Hasan
dc.contributor.authorTeke, Kerem
dc.contributor.authorSuer, Evren
dc.contributor.authorIzol, Volkan
dc.contributor.authorAkgul, Haci Murat
dc.contributor.authorSelvi, Ismail
dc.date.accessioned2024-10-29T17:58:30Z
dc.date.available2024-10-29T17:58:30Z
dc.date.issued2024
dc.departmentTekirdağ Namık Kemal Üniversitesi
dc.description.abstractPurpose: There is a lack of studies in the literature to evaluate the impact of the specific benefit of the use of neo-adjuvant chemotherapy (NAC) on the negative effect of lymphovascular invasion (LVI) on prognosis. We aimed to evaluate the survival differences of patients according to the presence of LVI with and without administration of NAC before radical cystectomy (RC). Materials and methods: We retrospectively evaluated data of the patients who underwent RC with pelvic lymphadenectomy and urinary diversion for bladder cancer recorded in the bladder cancer database of the Turkish Uro-oncology Association between 2007 and 2021. Patient demographics, follow-up time and overall survival (OS) were noted. Results: A total of 633 subjects included in the analyses. Median follow-up time was 24 months (IQR 12-54). Five years OS of the whole cohort was 55.1%. This was 54.7% and 59.9% in NAC- and NAC+ groups (P = 0.683), respectively. It was also 35.7% and 65.7% in LVI+ and LVI- patients (P < 0.0001), respectively. There was a significant difference between LVI+ and LVI- patients (33.2% vs. 68.2%, P < 0.0001) in NAC- group, but similar 5-year OS was found (53.2% vs. 64.5%, P = 0.552) in NAC+ group. In multivariable analyses, female gender, pN stages, presence of variant histology and LVI were significant independent predictive factors for OS in the whole cohort and in the NAC- group. However, gender association, pN stages and LVI lost significance in NAC+ group. Conclusion: Presence of LVI significantly reduced OS, and the NAC treatment improved the negative effects of LVI on OS. Our findings encourage the use of NAC before RC. (c) 2023 Elsevier Inc. All rights reserved.
dc.identifier.doi10.1016/j.urolonc.2023.09.007
dc.identifier.endpage300000000
dc.identifier.issn1078-1439
dc.identifier.issn1873-2496
dc.identifier.issue2en_US
dc.identifier.pmid37867054
dc.identifier.scopus2-s2.0-85174736057
dc.identifier.scopusqualityQ1
dc.identifier.startpage300
dc.identifier.urihttps://doi.org/10.1016/j.urolonc.2023.09.007
dc.identifier.urihttps://hdl.handle.net/20.500.11776/14361
dc.identifier.volume42
dc.identifier.wosWOS:001170852400001
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier Science Inc
dc.relation.ispartofUrologic Oncology-Seminars and Original Investigations
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectNeo-adjuvant chemotherapy
dc.subjectBladder cancer
dc.subjectLymphovascular invasion
dc.subjectSurvival
dc.titleDoes neo-adjuvant chemotherapy improve the negative effect of lymphovascular invasion in survival after radical cystectomy?
dc.typeArticle

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