Mp53-02 Risk of Node Metastases in Muscle Invasive Bladder Cancer Patients Treated With Neoadjuvant Chemo- Or Immunotherapy and Radical Cystectomy With Bilateral Pelvic Lymph Node Dissection

You have accessJournal of UrologyBladder Cancer: Invasive V (MP53)1 May 2024MP53-02 RISK OF NODE METASTASES IN MUSCLE INVASIVE BLADDER CANCER PATIENTS TREATED WITH NEOADJUVANT CHEMO- OR IMMUNOTHERAPY AND RADICAL CYSTECTOMY WITH BILATERAL PELVIC LYMPH NODE DISSECTION Mattia Longoni, Pietro Scilipoti, Mario De Angelis, Chiara Re, Alessandro Bertini, Leonardo Quarta, Giusy Burgio, Malvestiti Marco, Francesco Cattafi, Riccardo Leni, Giacomo Musso, Giulio Avesani, Francesco Pellegrino, Giuseppe Rosiello, Umberto Capitanio, Giorgio Gandaglia, Andrea Necchi, Daniele Raggi, Roberta Lucianò, Renzo Colombo, Andrea Salonia, Alberto Briganti, Francesco Montorsi, and Marco Moschini Mattia LongoniMattia Longoni , Pietro ScilipotiPietro Scilipoti , Mario De AngelisMario De Angelis , Chiara ReChiara Re , Alessandro BertiniAlessandro Bertini , Leonardo QuartaLeonardo Quarta , Giusy BurgioGiusy Burgio , Malvestiti MarcoMalvestiti Marco , Francesco CattafiFrancesco Cattafi , Riccardo LeniRiccardo Leni , Giacomo MussoGiacomo Musso , Giulio AvesaniGiulio Avesani , Francesco PellegrinoFrancesco Pellegrino , Giuseppe RosielloGiuseppe Rosiello , Umberto CapitanioUmberto Capitanio , Giorgio GandagliaGiorgio Gandaglia , Andrea NecchiAndrea Necchi , Daniele RaggiDaniele Raggi , Roberta LucianòRoberta Lucianò , Renzo ColomboRenzo Colombo , Andrea SaloniaAndrea Salonia , Alberto BrigantiAlberto Briganti , Francesco MontorsiFrancesco Montorsi , and Marco MoschiniMarco Moschini View All Author Informationhttps://doi.org/10.1097/01.JU.0001008784.37684.bd.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Almost 20% of cN0 cT2-4a bladder cancer (BCa) patients harbour pathologically confirmed lymph node (LN) metastases. Sparse data exists regarding the impact of neoadjuvant chemotherapy (NAC) and/or immunotherapy (NAI) on these findings. Therefore, our study aims to assess pathological LNI in a large cohort of cN0 patients undergoing radical cystectomy (RC) and bilateral pelvic lymph node dissection (bPLND). METHODS: 346 cN0 cT2-4a BCa patients treated with RC+bPLND at a tertiary referral centre between 2015 and 2023 were included. Standard (S), extended (E), or super-extended (SE) templates for PLND were used. Patients were stratified according to neoadjuvant therapy in 4 groups: no therapy (n=174,50.3%), NAC (n=58,16.7%), NAI (n=76,22.0%), or both (n=38,11.0%). Choice of neoadjuvant therapy was made upon oncological evaluation, based on patient's and tumour's characteristics. At final pathology, number of positive and removed LNs as well as anatomical location were reported. Student T-test was used to compare rate of LNI between groups. Logistic multivariable analysis (MVA), adjusting for age, pre-operative T-stage, previous carcinoma in situ (CIS), type of surgery (open vs robot-assisted), number of LNs removed, and PLND template, predicted the association between neoadjuvant therapy and presence of LNI. RESULTS: Median number of removed and positive LNs were 22 (IQR 16-30) and 2 (IQR 1-4), respectively. At bPLND, E- or SE-template was used in 223 (70.8%) cases. LNI was found in 63 (18.2%) patients. Obturator, internal, external, common iliac, and pre-sacral LNs were involved in 32 (50.8%), 12 (19.0%), 26 (41.3%), 13 (20.6%), and 2 (3.2%) patients, respectively. Distribution of LNI rates between groups was as follows: 44 (25.3%) patients receiving no therapy vs. 9 (15.5%) receiving NAC (ns) vs. 6 (7.9%) receiving NAI (p<0.001) vs. 4 (10.5%) receiving both (p<0.05). At logistic MVA, the use of NAC (OR 0.27, p=0.033), NAI (OR 0.16, p=0.005) or both (OR 0.22, p=0.03) was significantly associated with lower risk of LNI. CONCLUSIONS: cN0 BCa patients receiving NAC or NAI have lower risk of pathological LNI. Our preliminary results could be further developed in future studies assessing the need of E- or SE-bPLND in this specific setting. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e862 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Mattia Longoni More articles by this author Pietro Scilipoti More articles by this author Mario De Angelis More articles by this author Chiara Re More articles by this author Alessandro Bertini More articles by this author Leonardo Quarta More articles by this author Giusy Burgio More articles by this author Malvestiti Marco More articles by this author Francesco Cattafi More articles by this author Riccardo Leni More articles by this author Giacomo Musso More articles by this author Giulio Avesani More articles by this author Francesco Pellegrino More articles by this author Giuseppe Rosiello More articles by this author Umberto Capitanio More articles by this author Giorgio Gandaglia More articles by this author Andrea Necchi More articles by this author Daniele Raggi More articles by this author Roberta Lucianò More articles by this author Renzo Colombo More articles by this author Andrea Salonia More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Marco Moschini More articles by this author Expand All Advertisement PDF downloadLoading ...