Post-cystectomy chemo delay still effective

Delaying the initiation of adjuvant chemotherapy following radical cystectomy for locally advanced bladder cancer does not impact overall survival, according to a study reported in Urology.

The retrospective cohort study used the National Cancer Data Base from 2006 to 2013 and included 3590 patients who underwent radical cystectomy for muscle-invasive bladder cancer found to have locally advanced disease.

Compared with patients who did not receive chemotherapy, adjuvant chemotherapy decreased mortality with a similar hazard ratio (HR), regardless of whether it was started 31–60 days (HR, 0.60; 95% confidence interval [CI], 0.52–0.69; p<0.001), 61–90 days (HR, 0.62; 95% CI, 0.53­–0.74; p<0.001), or 91–180 days following radical cystectomy (HR, 0.69; 95% CI, 0.55–0.87; p=0.002).

According to the authors, the survival benefit of adjuvant chemotherapy persists even if initiation is delayed up to six months after radical cystectomy. This knowledge may increase the number of patients who can be considered for chemotherapy after a prolonged recovery from radical cystectomy.

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