Table 2. Univariable, Multivariable, and Propensity-Weighted Regression Analyses of Downstaging by NAC Regimen or No NAC.
| Chemotherapy Regimen | Total No. | Downstaged, No. (%) | Unadjusted OR (95% CI) | P Value | Adjusted OR (95% CI)a | P Value | Propensity Score Adjusted OR (95% CI)b | P Value |
|---|---|---|---|---|---|---|---|---|
| Downstaged to pT0N0 | ||||||||
| Gemcitabine-cisplatin | 204 | 50 (24.5) | 1 [Reference] | 1 [Reference] | 1 [Reference] | |||
| Gemcitabine-carboplatin | 32 | 3 (9.4) | 0.34 (0.09-1.09) | .07 | 0.46 (0.17-1.25) | .13 | ||
| ddMVAC | 46 | 19 (41.3) | 2.17 (1.11-4.23) | .02 | 2.67 (1.50-4.77) | <.001 | 1.52 (0.99-2.35) | .05 |
| Other | 50 | 12 (24.0) | 0.97 (0.47-2.00) | .94 | 1.44 (0.78-2.63) | .24 | ||
| None | 777 | 83 (10.7) | 0.37 (0.25-0.55) | <.001 | 0.44 (0.30-0.64) | <.001 | ||
| Any downstaging | ||||||||
| Gemcitabine-cisplatin | 204 | 92 (41.3) | 1 [Reference] | 1 [Reference] | 1 [Reference] | |||
| Gemcitabine-carboplatin | 32 | 10 (27.0) | 0.49 (0.21-1.13) | .10 | 0.61 (0.31-1.20) | .15 | ||
| ddMVAC | 46 | 24 (52.2) | 1.74 (0.91-3.30) | .09 | 1.84 (1.10-3.09) | .02 | 1.62 (1.05-2.50) | .03 |
| Other | 50 | 29 (42.0) | 1.15 (0.61-2.14) | .67 | 1.31 (0.79-2.16) | .30 | ||
| None | 767 | 186 (25.7) | 0.52 (0.38-0.72) | <.001 | 0.59 (0.44-0.79) | <.001 | ||
| Overall survival | Total No. (%) | HR (95% CI) | HR (95% CI) | HR (95% CI) | ||||
| Gemcitabine-cisplatin | 204 (61.5) | NA | 1 [Reference] | 1 [Reference] | 1 [Reference] | |||
| Gemcitabine-carboplatin | 32 (9.6) | NA | 2.01 (1.19-3.38) | .01 | 2.00 (1.16-3.44) | .01 | ||
| ddMVAC | 46 (13.9) | NA | 0.42 (0.17-1.05) | .06 | 0.42 (0.17-1.06) | .07 | 0.44 (0.14-1.38) | .16 |
| Other | 50 (15.1) | NA | 1.51 (0.96-2.38) | .07 | 1.65 (1.05-2.80) | .03 |
Abbreviations: ddMVAC, dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin; HR, hazard ratio; NAC, neoadjuvant chemotherapy; NA, not applicable because downstaging is shown in rows above; and OR, odds ratio.
a
Adjusted for age, comorbidity, sex, clinical stage, and chemotherapy regimen. The number of cycles was included for calculation of HRs.
b
Weighted for age, comorbidity, sex, clinical stage, race/ethnicity, marital status, ethnicity, insurance, histology, diversion type, number of cycles of chemotherapy. Dose-dense MVAC was compared with gemcitabine-cisplatin.