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- W1988637640 abstract "You have accessJournal of UrologyBladder Cancer: Invasive II1 Apr 2014MP55-04 PARTIAL CYSTECTOMY POST NEOADJUVANT CHEMOTHERAPY: MEMORIAL SLOAN-KETTERING CANCER CENTER CONTEMPORARY EXPERIENCE Wassim Bazzi, Ryan Kopp, Timothy Donahue, Melanie Bernstein, Paul Russo, Bernard Bochner, Sherri Donat, Guido Dalbagni, and Harry Herr Wassim BazziWassim Bazzi More articles by this author , Ryan KoppRyan Kopp More articles by this author , Timothy DonahueTimothy Donahue More articles by this author , Melanie BernsteinMelanie Bernstein More articles by this author , Paul RussoPaul Russo More articles by this author , Bernard BochnerBernard Bochner More articles by this author , Sherri DonatSherri Donat More articles by this author , Guido DalbagniGuido Dalbagni More articles by this author , and Harry HerrHarry Herr More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1552AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Partial cystectomy (PC) results in similar oncologic outcomes compared to radical cystectomy (RC) for selected patients while preserving quality of life. We report our experience with PC post-neoadjuvant chemotherapy (NC). Methods IRB approved review of patients treated with NC and PC for bladder urothelial cell carcinoma at Memorial Sloan-Kettering Cancer Center from 1995 to 2013. Variables included age, gender, race, tumor size, focality, histology, presence of carcinoma in situ (CIS), NC, clinical and pathologic stages, surgical margins (SM), disease status, and cause of death. We analyzed variables for association with recurrence free survival (RFS - defined as any recurrence), advanced recurrence free survival (ARFS - recurrence beyond salvage with intravesical therapy or RC), and overall survival (OS - death from any cause) via log-rank and Cox regression. Results Thirty six patients underwent NC and PC. Median age and follow up for the cohort were 69.7 yrs (IQR 58.8-76.8) and 16.8 mo (IQR 9.3-38.7). All tumors were solitary and < 5cm. Pre-NC, 22 (61%) were cT2, 21 (58%) had CIS, and 6 (17%) had N+. Post-NC, 21 (58%) were cT0, 5 (14%) had CIS, and 4 (11%) had N+. PC pathologic findings were pT0 in 18 (50%), CIS in 14 (39%), N+ in 4 (11%), and SM+ in 3 (8%). Of the post-NC 21 cT0, 7 (33%) had residual bladder disease at PC. At last follow up, 22 (61%) patients had intact bladder, 15 were with no evidence of disease (NED) and had no recurrences, 4 NED but had bladder recurrences salvaged by intravesical BCG (2) or RC (2), 1 NED after irradiation of brain metastasis. Four were alive with disease in the pelvis (2) and retroperitoneum (2). Of pts with known follow-up (n=35), 10 died of disease (1 had preventable death) at a median of 17.5 mo (IQR 11.3-37.5) and 1 died of other cause. Five year RFS, ARFS and OS were 28 %, 51%, and 63% respectively (figure). On multivariable analysis, the presence of post-NC N+ was associated with worse RFS (HR 14.5, p=0.048) and SM+ was associated with worse RFS (HR 6.7, p=0.02), ARFS (HR 6.0, p=0.04) and OS (HR 6.7, p=0.047). Conclusions PC with NC provides acceptable oncologic outcomes in highly selected patients with muscle invasive bladder cancer. Positive surgical margin at the time of PC is independently associated with worse RFS, ARFS and OS. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e556 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Wassim Bazzi More articles by this author Ryan Kopp More articles by this author Timothy Donahue More articles by this author Melanie Bernstein More articles by this author Paul Russo More articles by this author Bernard Bochner More articles by this author Sherri Donat More articles by this author Guido Dalbagni More articles by this author Harry Herr More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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- W1988637640 title "MP55-04 PARTIAL CYSTECTOMY POST NEOADJUVANT CHEMOTHERAPY: MEMORIAL SLOAN-KETTERING CANCER CENTER CONTEMPORARY EXPERIENCE" @default.
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