Researchers at the Icahn School of Medicine at Mount Sinai Hospital (NY, USA) have found that chemotherapy in combination with bladder cancer surgery is associated with approximately 30% lower risk of death compared with surgery alone. The findings were presented at the 2015 Genitourinary Cancers Symposium (held 26–28 February, FL, USA).
Previous clinical trials have demonstrated that it is beneficial to administer chemotherapy prior to surgery for bladder cancer. However, clinical trials investigating the effects of adjuvant chemotherapy have proved difficult to interpret and a number of trials were not completed.
Led by Matthew Galsky (Mount Sinai Hospital), the researchers analyzed a database of 5653 patients diagnosed with bladder cancer in the USA. Of these patients, 1293 individuals received adjuvant chemotherapy and 4360 received surgery alone. The study found that patients receiving adjuvant chemotherapy after surgical treatment had improved overall survival rates compared with patients who received surgical treatment alone.
“Until now, data supporting adjuvant chemotherapy has been mixed,” explained Galsky. “Our analysis of actual cases supports the use of chemotherapy after surgery for patients with locally advanced bladder cancer.”
“Chemotherapy prior to surgery remains the optimal approach for patients with bladder cancer based on the available evidence. However, population-based observational studies may be used to help fill the knowledge void in situations where clinical trials have not yielded definitive evidence. This comparative effectiveness analysis may help inform the care of patients with bladder cancer who have not received chemotherapy prior to surgery,” he continued.