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首页> 外文期刊>BMC Urology >The long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy combined with radical cystectomy versus radical cystectomy alone for bladder cancer: a propensity-score matching study
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The long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy combined with radical cystectomy versus radical cystectomy alone for bladder cancer: a propensity-score matching study

机译：单次Neoadjuvant内动脉化疗的长期疗效与自由基膀胱切除术相比单独用于膀胱癌的激进膀胱切除术：一种倾向 - 分数匹配研究

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Bladder cancer is a complex disease associated with high morbidity and mortality. Management of bladder cancer before radical cystectomy continues to be controversial. We compared the long-term efficacy of one-shot neoadjuvant intra-arterial chemotherapy (IAC) versus no IAC (NIAC) before radical cystectomy (RC) for bladder cancer. We performed a retrospective review of patients who underwent either one-shot IAC or NIAC before RC between October 2006 and November 2015. A propensity-score matching (1:3) was performed based on key characters. The Kaplan-Meier method was utilized to estimate survival probabilities, and the log-rank test was used to compare survival outcomes between different groups. A multivariable Cox proportional hazard model was used to estimate survival outcomes. Twenty-six patients were treated using IAC before RC, and 123 NIAC patients also underwent RC. After matching, there was no significant difference between groups in baseline characteristics, perioperative variables, complication outcomes or tumor characteristics. Compared with clinical tumor stages, pathological tumor stages demonstrated a significant decrease (P?=?0.002) in the IAC group. There was no significant difference in overall survival (OS, p?=?0.354) or cancer-specific survival (CSS, p?=?0.439) between the groups. Among all patients, BMI significantly affected OS (p?=?0.004), and positive lymph nodes (PLN) significantly affected both OS (p0.001) and CSS (p?=?0.010). One-shot neoadjuvant IAC before RC shows safety and tolerability and provides a significant advantage in pathological downstaging but not in OS or CSS. Further study of neoadjuvant combination therapeutic strategies with RC is needed.
机译：膀胱癌是一种与高发病率和死亡率相关的复杂疾病。在自由基膀胱切除术前继续进行膀胱癌的管理仍然存在争议。我们比较了一次性新辅助动脉内化疗（IAC）与膀胱癌的自由基膀胱切除术（RC）之前的一次动脉内化疗（IAC）的长期疗效。我们对2006年10月和2015年11月之间的RC之前进行了一次接受单次IAC或NIAC的患者进行了回顾性审查。基于关键特征进行倾向评分匹配（1：3）。 KAPLAN-MEIER方法用于估计存活概率，并且使用对数秩检验来比较不同组之间的生存结果。使用多变量的Cox比例危险模型来估算存活结果。在RC之前使用IAC治疗二十六名患者，123名患者也接受了RC。匹配后，基线特征，围手术会，并发症结果或肿瘤特征之间没有显着差异。与临床肿瘤阶段相比，病理肿瘤阶段在IAC组中表现出显着的降低（P？= 0.002）。总体存活（OS，P？= 0.354）或癌症特异性生存（CSS，P？= 0.439）没有显着差异。在所有患者中，BMI显着影响OS（P？= 0.004），阳性淋巴结（PLN）显着影响OS（P <0.001）和CSS（P？= 0.010）。 RC之前的一次性新辅助IAC显示安全性和耐受性，并在病理下降中提供显着的优势，但不在OS或CSS中。需要进一步研究Neoadjuvant组合与RC的治疗策略。

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