Abstract:
OBJECTIVES:To characterise the outcomes of neoadjuvant chemotherapy (NAC) pre-treated patients found to be lymph node (LN)-positive at the time of radical cystectomy and pelvic lymph node dissection (RC/PLND) for urothelial carcinoma of the bladder (UCB). PATIENTS AND METHODS:Of 1484 patients treated with RC/PLND for UCB from 2000 to 2010, we analysed 198 patients with clinically non-metastatic (cN0M0) muscle-invasive UCB who were found to be LN-positive at RC/PLND. As patients not receiving perioperative chemotherapy were significantly older and comorbid, we compared LN-positive patients previously treated with NAC (32 patients) to LN-positive patients treated with adjuvant chemotherapy (AC, 49 patients) using Cox proportional hazards models. A sensitivity analysis was designed to account for the additional time to RC in NAC patients. RESULTS:The 3-year recurrence-free survival estimate for LN-positive NAC patients was 26%, compared with 60% for LN-positive AC patients. LN-positive patients treated with NAC had significantly higher risks of disease recurrence and cancer-specific mortality in univariate analyses (hazard ratio [HR] 2.86, 95% confidence interval [CI] 1.58-5.19, P = 0.001 and HR 2.50, 95% CI 1.34-4.65, P = 0.004, respectively) and multivariable analyses adjusting for pathological stage and LN density (HR 3.11, 95% CI 1.59-6.07, P = 0.001 and HR 3.05, 95% CI 1.46-6.35, P = 0.003, respectively). Sensitivity analyses similarly demonstrated worse outcomes for NAC pre-treated LN-positive patients. CONCLUSION:LN-positive patients previously treated with NAC have a poor prognosis, significantly worse than LN-positive patients subsequently treated with AC, and should be considered for protocols using sandwich chemotherapy approaches or novel agents. These results should be considered in the interpretation of and stratification for clinical trials.
journal_name
BJU Intjournal_title
BJU internationalauthors
Cha EK,Sfakianos JP,Sukhu R,Yee AM,Sjoberg DD,Bochner BHdoi
10.1111/bju.14242subject
Has Abstractpub_date
2018-10-01 00:00:00pages
627-632issue
4eissn
1464-4096issn
1464-410Xjournal_volume
122pub_type
杂志文章abstract:OBJECTIVE:To describe metoidioplasty, a technique for creating a neophallus from an enlarged clitoris in female transsexuals, without needing the complex, multi-staged surgical construction of a large phallus, as this reconstruction is one of the most difficult in female transsexuals. PATIENTS AND METHODS:From Septemb...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410x.2003.04524.x
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:To provide an up-to-date summary of current literature on the management of adverse effects of androgen-deprivation therapy (ADT). PATIENTS AND METHODS:All relevant medical literature on men with prostate cancer treated with ADT from 2005 to 2014, and older relevant papers, were reviewed. Recent health advis...
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pub_type: 杂志文章,评审
doi:10.1111/bju.12964
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2010.09484.x
更新日期:2010-12-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.15161
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.07735.x
更新日期:2008-09-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2009-04-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1111/j.1464-410X.2012.11042.x
更新日期:2012-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/j.1464-410X.2004.04815.x
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pub_type: 杂志文章
doi:10.1111/bju.13772
更新日期:2017-06-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.08038.x
更新日期:2009-02-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章,meta分析,评审
doi:10.1111/j.1464-410X.2009.08422.x
更新日期:2009-08-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2002.02776.x
更新日期:2002-06-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2012.11203.x
更新日期:2013-03-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.07941.x
更新日期:2009-01-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.12597
更新日期:2014-11-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1464-410x.2004.04557.x
更新日期:2004-01-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.12387
更新日期:2014-02-01 00:00:00
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pub_type: 杂志文章,多中心研究
doi:10.1111/bju.12542
更新日期:2014-10-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2006.06541.x
更新日期:2007-02-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2014-04-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2007.07338.x
更新日期:2008-03-01 00:00:00
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pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1464-410X.2008.07845.x
更新日期:2008-09-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2010.09418.x
更新日期:2010-11-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1111/j.1464-410X.2005.05488.x
更新日期:2005-06-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1111/j.1464-410X.2010.09829.x
更新日期:2011-04-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2004.05034.x
更新日期:2004-10-01 00:00:00
abstract::Patients with metastatic bone disease often have severe bone pain and debilitating skeletal complications. Zoledronic acid is the only bisphosphonate shown to be safe and effective in reducing skeletal-related events (SREs), including pathological fractures, spinal cord compression, and radiation or surgery to bone in...
journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1111/j.1464-410X.2005.05740.x
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVE:To test whether salvage radiotherapy (SRT) in patients with lymph node negative (N0) prostate cancer is equally effective with persistent prostate-specific antigen (PSA) and PSA rising from the undetectable range (<0.1 ng/mL) after radical prostatectomy (RP). PATIENTS AND METHODS:We assessed post-SRT PSA pro...
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doi:10.1111/bju.14851
更新日期:2019-11-01 00:00:00
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更新日期:2015-04-01 00:00:00