Table 1 –
General characteristics of the study patients
| Characteristic | Overall | No NAC or AC | NAC | AC | NAC + AC |
|---|---|---|---|---|---|
| Median age at surgery, yr (range) | 68 (60.2–74) | 71 (63–77) | 64 (57–70) | 65 (56–70) | 62 (55–68) |
| Median LNs removed, n (range) | 15 (9–22) | 15 (9–22) | 16 (10–22) | 16 (10–24) | 20.5 (14–26.5) |
| Race, n (%) | |||||
| Caucasian | 850 (89.5) | 479 (87.9) | 229 (94.6) | 128 (87.7) | 14 (82.4) |
| Hispanic or Latino | 69 (7.3) | 51 (9.4) | 1 (0.4) | 16 (11) | 1 (5.9) |
| Black | 22 (2.3) | 9 (1.7) | 9 (3.7) | 2 (1.4) | 2 (11.8) |
| Other or mixed | 9 (0.9) | 6 (1.1) | 3 (1.2) | 0 (0) | 0 (0) |
| Smoking status, n (%) | |||||
| Never smoker | 192 (20.2) | 111 (20.4) | 55 (22.7) | 22 (15.1) | 4 (23.5) |
| Current smoker | 215 (22.6) | 110 (20.2) | 62 (25.6) | 39 (26.7) | 4 (23.5) |
| Former smoker | 351 (36.9) | 179 (32.8) | 108 (44.6) | 57 (39) | 7 (41.2) |
| Unknown | 192 (20.2) | 145 (26.6) | 17 (7) | 28 (19.2) | 2 (11.8) |
| CCI, n (%) | |||||
| 0 | 288 (30.3) | 133 (24.4) | 100 (41.3) | 47 (32.2) | 8 (47.1) |
| ≥1 | 567 (59.7) | 377 (69.2) | 89 (36.8) | 92 (63) | 9 (52.9) |
| Unknown | 95 (10) | 35 (6.4) | 53 (21.9) | 7 (4.8) | 0 (0) |
| Histology, n (%) | |||||
| Pure UC | 826 (86.9) | 474 (87) | 206 (85.1) | 129 (88.4) | 17 (100) |
| UC with divergent histology | 124 (13.1) | 71 (13) | 36 (14.9) | 17 (11.6) | 0 (0) |
| cT stage, n (%) | |||||
| cT2 | 567 (59.7) | 319 (58.5) | 145 (59.9) | 91 (62.3) | 12 (70.6) |
| cT3–4 | 223 (23.5) | 100 (18.3) | 91 (37.6) | 29 (19.9) | 3 (17.6) |
| Unknown | 160 (16.8) | 126 (23.1) | 6 (2.5) | 26 (17.8) | 2 (11.8) |
| pT stage, n (%) | |||||
| pT0 | 96 (10.1) | 17 (3.1) | 79 (32.6) | 0 (0) | 0 (0) |
| pT1 | 63 (6.6) | 43 (7.9) | 16 (6.6) | 3 (2.1) | 1 (5.9) |
| pT2 | 189 (19.9) | 121 (22.2) | 42 (17.4) | 21 (14.4) | 5 (29.4) |
| pT3 | 389 (40.9) | 232 (42.6) | 65 (26.9) | 84 (57.5) | 8 (47.1) |
| pT4 | 154 (16.2) | 94 (17.2) | 20 (8.3) | 37 (25.3) | 3 (17.6) |
| pTa/pTis | 59 (6.2) | 38 (7) | 20 (8.3) | 1 (0.7) | 0 (0) |
| pN stage, n (%) | |||||
| pN0 | 644 (67.8) | 379 (69.5) | 197 (81.4) | 61 (41.8) | 7 (41.2) |
| pN1 | 102 (10.7) | 50 (9.2) | 20 (8.3) | 31 (21.2) | 1 (5.9) |
| pN2 | 160 (16.8) | 89 (16.3) | 21 (8.7) | 43 (29.5) | 7 (41.2) |
| pN3 | 16 (1.7) | 7 (1.3) | 1 (0.4) | 6 (4.1) | 2 (11.8) |
| pNX | 28 (2.9) | 20 (3.7) | 3 (1.2) | 5 (3.4) | 0 (0) |
| Margin status, n (%) | |||||
| Negative | 850 (89.5) | 490 (89.9) | 216 (89.3) | 132 (90.4) | 12 (70.6) |
| Positive | 84 (8.8) | 48 (8.8) | 20 (8.3) | 12 (8.2) | 4 (23.5) |
| NAC, n (%) | |||||
| No | 691 (72.7) | 545 (100) | 0 (0) | 146 (100) | 0 (0) |
| Yes | 259 (27.3) | – | 242 (100) | – | 17 (100) |
| NAC platinum regimen, n (%) a | |||||
| Carboplatin | 22 (2.3) | – | 20 (8.3) | – | 2 (11.8) |
| Cisplatin | 214 (22.5) | – | 203 (83.9) | – | 11 (64.7) |
| Unknown | 23 (2.4) | – | 19 (7.9) | – | 4 (23.5) |
| Median NAC cycles, n (range) | 3 (2–6) | – | 3 (2–6) | – | 3 (2–4) |
| AC, n (%) | |||||
| No | 787 (82.8) | 545 (100) | 242 (100) | 0 (0) | 0 (0) |
| Yes | 163 (17.2) | 0 (0) | 0 (0) | 146 (100) | 17 (100) |
| AC platinum regimen, n (%) b | |||||
| Carboplatin | 20 (2.1) | 0 (0) | 0 (0) | 18 (12.3) | 2 (11.8) |
| Cisplatin | 83 (8.7) | 0 (0) | 0 (0) | 73 (50) | 10 (58.8) |
| Unknown | 60 (6.3) | 0 (0) | 0 (0) | 55 (37.7) | 5 (29.4) |
| Median AC cycles, n (range) | 4 (2–6) | – | – | 4 (2–6) | 4 (2–4) |
| Outcomes | – | – | |||
| RFS, n (%) | |||||
| No | 551 (58) | 313 (57.4) | 160 (66.1) | 71 (48.6) | 7 (41.2) |
| Yes | 399 (42) | 232 (42.6) | 82 (33.9) | 75 (51.4) | 10 (58.8) |
| Site of relapse, n (%) | |||||
| Distant | 334 (35.2) | 192 (35.2) | 68 (28.1) | 67 (45.9) | 7 (41.2) |
| Local | 63 (6.6) | 38 (7) | 13 (5.4) | 9 (6.2) | 3 (17.6) |
| Not specified | 3 (0.3) | 2 (0.4) | 1 (0.4) | 0 (0) | 0 (0) |
| Unknown | 550 (57.9) | 313 (57.4) | 160 (66.1) | 70 (47.9) | 7 (41.2) |
| Status at last follow-up, n (%) | |||||
| Alive | 575 (60.5) | 306 (56.1) | 176 (72.7) | 83 (56.8) | 10 (58.8) |
| Died of disease | 288 (30.3) | 177 (32.5) | 50 (20.7) | 55 (37.7) | 6 (35.3) |
| Died of other causes | 83 (8.7) | 58 (10.6) | 16 (6.6) | 8 (5.5) | 1 (5.9) |
AC = adjuvant chemotherapy; CCI = Charlson comorbidity index; CMV = cisplatin, methotrexate, vinblastine; DD = dose-dense; LN = lymph node; MVAC = methotrexate, vinblastine, doxorubicin, cisplatin; NAC = neoadjuvant chemotherapy; RFS = relapse-free survival; UC = urothelial carcinoma.
a
NAC regimens: CMV, n = 5; DD-MVAC, n = 36; MVAC, n = 11; gemcitabine-cisplatin, n = 162; gemcitabine-carboplatin, n = 22; unknown regimen (23)
b
AC regimens: DD-MVAC, n = 5; MVAC, n = 15; gemcitabine-cisplatin, n = 63; gemcitabine-carboplatin, n = 20.