Quality of pathologic response and surgery correlate with survival for patients with completely resected bladder cancer after neoadjuvant chemotherapy.

BACKGROUND: In a retrospective study of Southwestern Oncology Group (SWOG)-S8710/INT-0080 (radical cystectomy [RC] alone vs 3 cycles of neoadjuvant chemotherapy [NC] with methotrexate, vinblastine, doxorubicin, and cisplatin before RC for bladder cancer), factors found to be associated with improved overall survival (OS) included pathologic complete response, defined as P0; treatment with NC; completion of RC with negative surgical margins; and >or=10 pelvic lymph nodes (LNs) removed.

METHODS: The authors used stratified Cox regression to retrospectively study the association of quality of pathologic response after RC with OS in the subset of S8710 patients who received NC and RC with negative surgical margins.

RESULTS: Of 154 patients who received NC, 68 (44.2%) were
CONCLUSIONS: NC and RC with negative surgical margins for bladder cancer followed by pathologic P0 and LN- disease were found to correlate with improved OS. A combination of baseline clinical stage and post-RC pathologic stage may better predict OS.