The Impact of Chemotherapy After Bladder Cancer Surgery

Patients receiving chemotherapy after surgery had a 30% lower risk of death than those who had surgery alone.

Chemotherapy following surgery for bladder cancer may reduce the risk of death over surgery alone, a recent study indicates.

Researchers at the Icahn School of Medicine at Mount Sinai found that patients receiving chemotherapy after bladder cancer surgery had a risk of death approximately 30% lower than patients who only received surgery. The analysis is scheduled to be presented at the 2015 Genitourinary Cancers Symposium.

Previous clinical trials have shown the benefit of neoadjuvant chemotherapy in bladder cancer patients, however, studies evaluating adjuvant chemotherapy have been tough to interpret, as numerous trials closed early as a result of poor accrual. The researchers utilized an extensive database of cancer patients in the United States, which revealed those receiving adjuvant chemotherapy after surgery had improved overall survival compared with patients receiving surgical treatment alone with only post-surgical observation.

"Until now, data supporting adjuvant chemotherapy has been mixed," lead researcher Matthew Galsky, MD, said in a press release. "Our analysis of actual cases supports the use of chemotherapy after surgery for patients with locally advanced bladder cancer."

In 5653 patients included in the analysis, 1293 patients received adjuvant chemotherapy, while 4360 patients received surgery alone.

"Chemotherapy prior to surgery remains the optimal approach for patients with bladder cancer based on the available evidence,” Dr. Galsky said. “However, population-based observational studies may be used to help fill the knowledge void in situations where clinical trials have not yielded definitive evidence. This comparative effectiveness analysis may help inform the care of patients with bladder cancer who have not received chemotherapy prior to surgery."