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Trends in the Use of Chemotherapy before and after Radical Cystectomy in Patients with Muscle-invasive Bladder Cancer in Korea
Article 在 En | WPRIM | ID: wpr-47714
Responsible library: WPRO
ABSTRACT
We investigated trends in perioperative chemotherapy use, and determined factors associated with neoadjuvant chemotherapy (NAC) and adjuvant chemotherapy (AC) use in Korean patients with muscle-invasive bladder cancer (MIBC). We recruited 1,324 patients who had MIBC without nodal invasion or metastases and had undergone radical cystectomies (RC) between 2003 and 2013. The study's cut-off time for AC was three months after surgery, and the study's timespan was divided into three periods based on NAC use, namely, 2003-2005, 2006-2009, and 2010-2013. Complete remission was defined as histologically confirmed T0N0M0 after RC. NAC and AC were administered to 7.3% and 18.1% of the patients, respectively. The median time interval between completing NAC and undergoing RC was 32 days and the mean number of cycles was 3.2. The median time interval between RC and AC was 43 days and the mean number of cycles was 4.1. Gemcitabine and cisplatin were most frequently used in combination for NAC (49.0%) and AC (74.9%). NAC use increased significantly from 4.6% between 2003 and 2005 to 8.4% between 2010 and 2013 (P < 0.05), but AC use did not increase. Only 1.9% of patients received NAC and AC. Complete remission after NAC was achieved in 12 patients (12.5%). Multivariable modeling revealed that an advanced age, the earliest time period analyzed, and clinical tumor stage < or = cT2 bladder cancer were negatively associated with NAC use (P < 0.05). While NAC use has slowly increased over time, it remains an underutilized therapeutic approach in Korean clinical practice.
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全文: 1 索引: WPRIM 主要主题: Urinary Bladder Neoplasms / Practice Patterns, Physicians&apos; / Drug Administration Schedule / Cystectomy / Drug Administration Routes / Prevalence / Risk Factors / Treatment Outcome / Chemotherapy, Adjuvant / Neoadjuvant Therapy 研究类型: Etiology_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies 限制: Adult / Aged / Aged80 / Female / Humans / Male 国家/地区名称主题: Asia 语言: En 期刊: Journal of Korean Medical Science 年: 2015 类型: Article
全文: 1 索引: WPRIM 主要主题: Urinary Bladder Neoplasms / Practice Patterns, Physicians&apos; / Drug Administration Schedule / Cystectomy / Drug Administration Routes / Prevalence / Risk Factors / Treatment Outcome / Chemotherapy, Adjuvant / Neoadjuvant Therapy 研究类型: Etiology_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies 限制: Adult / Aged / Aged80 / Female / Humans / Male 国家/地区名称主题: Asia 语言: En 期刊: Journal of Korean Medical Science 年: 2015 类型: Article