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Vol.68 No.4,5,6 >

Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/3470

Title: Pretreatment Platelet-to-Lymphocyte Ratio as Biomarker for Neoadjuvant Chemotherapy Prior to Radical Cystectomy in Muscle-Invasive Bladder Cancer.
Authors: Kuwada, Masaomi
Miyake, Makito
Gotoh, Daisuke
Tatsumi, Yoshihiro
Nakai, Yasushi
Anai, Satoshi
Chihara, Yoshitomo
Hirao, Yoshihiko
Haramoto, Masaki
Tanaka, Nobumichi
Fujimoto, Kiyohide
Keywords: bladder cancer
chemotherapy
cisplatin
cystectomy
gemcitabine
Issue Date: 31-Dec-2017
Publisher: 奈良医学会
奈良県立医科大学
Citation: Journal of Nara Medical Association Vol.68 No.4,5,6 p.29-41 (2017.12)
Abstract: Objectives : To evaluate the clinical benefit of neoadjuvant chemotherapy with gemcitabine and cisplatin (GC) in patients with muscle-invasive bladder cancer treated with radical cystectomy and to identify patients who may benefit from neoadjuvant chemotherapy and predictors of therapeutic response to it. Methods : In this prospective study, we enrolled 37 patients with muscle-invasive bladder cancer (cT2-4aNanyM0). The primary endpoint was the pathological response rate at cystectomy after receiving neoadjuvant GC chemotherapy. Univariable and multivariable analyses were used to determine predictive factors of pT0N0 and ≦pT1N0. The secondary endpoints were adverse events during chemotherapy, surgical complications, as well as overall, disease-specific, and recurrence-free survival. Results : A mean of 2.7 cycles of neoadjuvant GC was administered. Pathological complete response (pT0N0), partial response (pTisN0/pT1N0), and pathological response (≦pT1N0) rates were 24.3%, 27.0%, and 5l.3%, respectively. Grade 3 or 4 non-hematologic adverse events were rare. Three-year overall, disease-specific, and recurrence-free survival rates were 70.7%, 8l.3%, and 63.9%, respectively. Patients with pathological response (≦pT1N0) demonstrated a significantly improved 3-year overall survival rate (94.7% vs. 42.8%), disease-specific survival rate (94.7% vs.62.9%), and recurrence-free survival rate (80.6% vs.45.5%), compared with pathological non-responders (≦pT2Nany). Clinical stage cT2 and low pre-chemotherapy platelet-to-lymphocyte ratios were significant indicators of favorable pathological response to neoadjuvant Gc. Conclusions : Neoadjuvant chemotherapy using GC is safe and effective in patients with muscle-invasive bladder cancer, Pretreatment clinical T2 stage and low platelet-to-lymphocyte ratios were predictive markers for successful neoadjuvant treatment of muscle-invasive bladder cancer with GC.
URI: http://hdl.handle.net/10564/3470
ISSN: 13450069
Appears in Collections:Vol.68 No.4,5,6

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