Chemotherapy before or after surgery for high-risk bladder cancer improves survival, but is not routinely administered

April 14, 2014

Contrary to treatment guidelines for high-risk bladder cancer, chemotherapy before or after surgery is not commonly used in routine clinical practice. The findings are published early online in Cancer, a peer-reviewed journal of the American Cancer Society.

Clinical trials have shown that survival is improved in patients with muscle-invasive who are given before surgery. There is less evidence about whether chemotherapy after surgery also improves survival. To investigate the use of peri-operative chemotherapy in this disease, Christopher Booth, MD, FRCPC, of the Queen's University Cancer Research Institute in Canada, examined records pertaining to all 2944 patients who had surgery for high-risk bladder cancer in Ontario between 1994 and 2008.

Use of chemotherapy before surgery remained stable (an average of 4 percent of patients) over the study period, which is surprising given the evidence that this is a standard of care that has been demonstrated to improve survival. The use of chemotherapy after surgery increased over time: 16 percent of in 1994 to 1998, 18 percent in 1999 to 2003, and 22 percent in 2004 to 2008. Study results showed that use of chemotherapy after surgery was associated with better survival.

"Results from our study demonstrate that chemotherapy given after surgery improves patient survival—probably on the same order of magnitude as chemotherapy before surgery," said Dr. Booth. "Patients having surgery for bladder cancer should have chemotherapy, either before or after surgery. Efforts are needed to improve uptake of this treatment, which appears to be vastly underutilized."

Explore further: Unexpected results in cancer drug trial

More information: "Peri-operative chemotherapy for muscle-invasive bladder cancer: A population-based outcomes study." Christopher M. Booth, D. Robert Siemens, Gavin Li, Yingwei Peng PhD, Ian F. Tannock, Weidong Kong, David M. Berman, and William J. Mackillop. Cancer; Published Online: April 14, 2014 (DOI: 10.1002/cncr.28510).

Related Stories

Unexpected results in cancer drug trial

April 8, 2014
Research from the University of Southampton has shown a drug, used in combination with chemotherapy to treat advanced colorectal cancer, is not effective in some settings, and indeed may result in more rapid cancer progression.

Surgery beats chemotherapy for tongue cancer, study finds

December 26, 2013
Patients with tongue cancer who started their treatment with a course of chemotherapy fared significantly worse than patients who received surgery first, according to a new study from researchers at the University of Michigan ...

Classification system for bladder cancer prognosis

January 29, 2014
Researchers at Lund University have developed a classification system to determine the prognosis for bladder cancer. It is hoped that this will prove useful for future bladder cancer research and drug development.

New study could improve survival rate of colon cancer patients

March 6, 2014
A unique trial at Queen's University could improve the survival rate of patients with colon cancer. This is the first study to test if exercise can improve the cure rate of colon cancer and improve quality of life and physical ...

Chemo, radiation followed by surgery improves survival in lung cancer patients

April 30, 2013
In one of the largest observational studies of its kind, researchers report that a combination of chemotherapy and radiation followed by surgery in patients with stage 3 non-small cell lung cancer improves survival.

Surgery and radiation improve survival for metastatic gastric cancer patients, study shows

February 27, 2013
Researchers at Moffitt Cancer Center studied patients with metastatic gastric cancer and found that those who have both surgery and radiation have better survival than those who receive one or no form of treatment.

Recommended for you

Study suggests colon cancer cells carry bacteria with them when they metastasize

November 24, 2017
(Medical Xpress)—A team of researchers working at Harvard University has found evidence that suggests a certain type of bacteria found in colon cancer tumors makes its way to tumors in other body parts by traveling with ...

Promising new treatment for rare pregnancy cancer leads to remission in patients

November 24, 2017
An immunotherapy drug can be used to cure women of a rare type of cancer arising from pregnancy when existing treatments have failed.

Researchers unravel novel mechanism by which tumors grow resistant to radiotherapy

November 23, 2017
A Ludwig Cancer Research study has uncovered a key mechanism by which tumors develop resistance to radiation therapy and shown how such resistance might be overcome with drugs that are currently under development. The discovery ...

African Americans face highest risk for multiple myeloma yet underrepresented in research

November 23, 2017
Though African-American men are three times more likely to be diagnosed with multiple myeloma, a type of blood cancer, most scientific research on the disease has been based on people of European descent, according to a study ...

Encouraging oxygen's assault on iron may offer new way to kill lung cancer cells

November 22, 2017
Blocking the action of a key protein frees oxygen to damage iron-dependent proteins in lung and breast cancer cells, slowing their growth and making them easier to kill. This is the implication of a study led by researchers ...

One-size treatment for blood cancer probably doesn't fit all, researchers say

November 22, 2017
Though African-American men are three times more likely to be diagnosed with a blood cancer called multiple myeloma, most scientific research on the disease has been based on people of European descent, according to a study ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.