The role of radical cystectomy and lymphadenectomy in the management of bladder cancer with clinically positive lymph node involvement.
Journal
Current opinion in urology
ISSN: 1473-6586
Titre abrégé: Curr Opin Urol
Pays: United States
ID NLM: 9200621
Informations de publication
Date de publication:
26 Sep 2024
26 Sep 2024
Historique:
medline:
1
10
2024
pubmed:
1
10
2024
entrez:
1
10
2024
Statut:
aheadofprint
Résumé
The role of radical cystectomy and pelvic lymph node dissection in muscle-invasive bladder cancer (MIBC) with clinically positive lymph nodes is debated. This review examines the role of surgery in treating patients with clinical N1 and more advanced nodal involvement (N2-N3) within a multimodal treatment approach. For clinical N1 disease, guidelines typically recommend neoadjuvant chemotherapy followed by surgery. However, for N2-N3 disease, guidelines vary. Advances in diagnostics, systemic therapies, and surgical recovery have improved the prognosis for these patients. Research is increasingly identifying MIBC patients, including those with positive nodes, who may achieve complete pathologic response and long-term survival, supporting the role of surgery even in advanced nodal stages. Managing MIBC with clinically positive lymph nodes, especially in N2-N3 disease, requires a tailored approach. While neoadjuvant chemotherapy followed by radical cystectomy is standard for N1 disease, the role of surgery in advanced nodal stages is growing because of better patient selection and treatment strategies. Emerging evidence suggests that consolidative surgery may improve outcomes in these complex cases.
Identifiants
pubmed: 39350629
doi: 10.1097/MOU.0000000000001230
pii: 00042307-990000000-00193
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Références
Mitra AP, Cai J, Miranda G, et al. Management trends and outcomes of patients undergoing radical cystectomy for urothelial carcinoma of the bladder: evolution of the University of Southern California experience over 3,347 cases. J Urol 2022; 207:302–313.
Grossman HB, Natale RB, Tangen CM, et al. Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med 2003; 349:859–866.
Stein JP, Lieskovsky G, Cote R, et al. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol 2001; 19:666–675.
Alfred Witjes J, Max Bruins H, Carrion A, et al. European Association of Urology guidelines on muscle-invasive and metastatic bladder cancer: summary of the 2023 guidelines. Eur Urol 2024; 85:17–31.
Holzbeierlein J, Bixler BR, Buckley DI, et al. Treatment of non-metastatic muscle-invasive bladder cancer: AUA/ASCO/SUO Guideline (2017; Amended 2020, 2024). J Urol 2024; 212:3–10.
Flaig TW, Spiess PE, Agarwal N, et al. Bladder cancer, Version 3.2020, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2020; 18:329–354.
Advanced Bladder Cancer Meta-analysis Collaboration Neoadjuvant chemotherapy in invasive bladder cancer: update of a systematic review and meta-analysis of individual patient data advanced bladder cancer (ABC) meta-analysis collaboration. Eur Urol 2005; 48:202–205.
Rosenblatt R, Sherif A, Rintala E, et al. Nordic Urothelial Cancer Group Pathologic downstaging is a surrogate marker for efficacy and increased survival following neoadjuvant chemotherapy and radical cystectomy for muscle-invasive urothelial bladder cancer. Eur Urol 2012; 61:1229–1238.
Pfister C, Gravis G, Flechon A, et al. VESPER Trial Investigators Randomized phase III Trial of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin, or gemcitabine and cisplatin as perioperative chemotherapy for patients with muscle-invasive bladder cancer. Analysis of the GETUG/AFU V05 VESPER Trial Secondary Endpoints: Chemotherapy Toxicity and Pathological Responses. Eur Urol 2021; 79:214–221.
Chung DY, Kang DH, Kim JW, et al. Comparison of oncologic outcomes of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (ddMVAC) with gemcitabine and cisplatin (GC) as neoadjuvant chemotherapy for muscle-invasive bladder cancer: systematic review and meta-analysis. Cancers (Basel) 2021; 13:2770.
Ghodoussipour S, Xu W, Tran K, et al. Preoperative chemotherapy in clinically node positive muscle invasive bladder cancer: radiologic variables can predict response. Urol Oncol 2021; 39: 133 e1-e8.
Zargar-Shoshtari K, Zargar H, Lotan Y, et al. A multi-institutional analysis of outcomes of patients with clinically node positive urothelial bladder cancer treated with induction chemotherapy and radical cystectomy. J Urol 2016; 195:53–59.
Meijer RP, Mertens LS, van Rhijn BW, et al. Induction chemotherapy followed by surgery in node positive bladder cancer. Urology 2014; 83:134–139.
Al-Alao O, Mueller-Leonhard C, Kim SP, et al. Clinically node-positive (cN+) urothelial carcinoma of the bladder treated with chemotherapy and radical cystectomy: clinical outcomes and development of a postoperative risk stratification model. Urol Oncol 2020; 38:76.e19–76.e28.
Hermans TJ, Fransen van de Putte EE, Horenblas S, et al. Pathological downstaging and survival after induction chemotherapy and radical cystectomy for clinically node-positive bladder cancer-results of a nationwide population-based study. Eur J Cancer 2016; 69:1–8.
Necchi A, Mariani L, Lo Vullo S, et al. Young Academic Urologists-Urothelial Carcinoma Group-European Association of Urology and the Retrospective International Study of Invasive/Advanced Cancer of the Urothelium group Lack of effectiveness of postchemotherapy lymphadenectomy in bladder cancer patients with clinical evidence of metastatic pelvic or retroperitoneal lymph nodes only: a propensity score-based analysis. Eur Urol Focus 2019; 5:242–249.
Jiang DM, Gupta S, Kitchlu A, et al. Defining cisplatin eligibility in patients with muscle-invasive bladder cancer. Nat Rev Urol 2021; 18:104–114.
Powles T, Kockx M, Rodriguez-Vida A, et al. Clinical efficacy and biomarker analysis of neoadjuvant atezolizumab in operable urothelial carcinoma in the ABACUS trial. Nat Med 2019; 25:1706–1714.
Necchi A, Anichini A, Raggi D, et al. Pembrolizumab as Neoadjuvant Therapy Before Radical Cystectomy in Patients With Muscle-Invasive Urothelial Bladder Carcinoma (PURE-01): an open-label, single-arm, phase II study. J Clin Oncol 2018; 36:3353–3360.
Lee CT, Madii R, Daignault S, et al. Cystectomy delay more than 3 months from initial bladder cancer diagnosis results in decreased disease specific and overall survival. J Urol 2006; 175:1262–1267.
Audenet F, Sfakianos JP, Waingankar N, et al. A delay >/=8 weeks to neoadjuvant chemotherapy before radical cystectomy increases the risk of upstaging. Urol Oncol 2019; 37:116–122.
Moschini M, Mattei A, Cornelius J, et al. Surgical treatment for clinical node-positive bladder cancer patients treated with radical cystectomy without neoadjuvant chemotherapy. World J Urol 2018; 36:639–644.
Afferi L, Lonati C, Montorsi F, et al. European Association of Urology Young Academic Urologists Urothelial Carcinoma Working Group Selecting the best candidates for cisplatin-based adjuvant chemotherapy after radical cystectomy among patients with pN+ bladder cancer. Eur Urol Oncol 2022; 5:722–725.
Bajorin DF, Witjes JA, Gschwend JE, et al. Adjuvant nivolumab versus placebo in muscle-invasive urothelial carcinoma. N Engl J Med 2021; 384:2102–2114.
Bellmunt J, Hussain M, Gschwend JE, et al. IMvigor010 Study Group Adjuvant atezolizumab versus observation in muscle-invasive urothelial carcinoma (IMvigor010): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 2021; 22:525–537.
Zehnder P, Studer UE, Daneshmand S, et al. Outcomes of radical cystectomy with extended lymphadenectomy alone in patients with lymph node-positive bladder cancer who are unfit for or who decline adjuvant chemotherapy. BJU Int 2014; 113:554–560.
Galsky MD, Stensland K, Sfakianos JP, et al. Comparative effectiveness of treatment strategies for bladder cancer with clinical evidence of regional lymph node involvement. J Clin Oncol 2016; 34:2627–2635.
Ahmadi H, Daneshmand S. Association between use of ERAS protocols and complications after radical cystectomy. World J Urol 2022; 40:1311–1316.
Ghodoussipour S, Naser-Tavakolian A, Cameron B, et al. Internal audit of an enhanced recovery after surgery protocol for radical cystectomy. World J Urol 2020; 38:3131–3137.
Kronstedt S, Doppalapudi SK, Boyle J, et al. Does time to adjuvant chemotherapy after radical cystectomy affect survival in muscle invasive bladder cancer? A systematic review. Cancers (Basel) 2022; 14:5644.
Donat SM, Shabsigh A, Savage C, et al. Potential impact of postoperative early complications on the timing of adjuvant chemotherapy in patients undergoing radical cystectomy: a high-volume tertiary cancer center experience. Eur Urol 2009; 55:177–185.
Lerner SP, Tangen C, Svatek RS, et al. SWOG S1011: a phase III surgical trial to evaluate the benefit of a standard versus an extended lymphadenectomy performed at time of radical cystectomy for muscle invasive urothelial cancer. J Clin Oncol 2023; 41: (16 Suppl): 4508.
Shipley WU, Winter KA, Kaufman DS, et al. Phase III trial of neoadjuvant chemotherapy in patients with invasive bladder cancer treated with selective bladder preservation by combined radiation therapy and chemotherapy: initial results of Radiation Therapy Oncology Group 89-93. J Clin Oncol 1998; 16:3576–3583.
Kaufman DS, Winter KA, Shipley WU, et al. The initial results in muscle-invading bladder cancer of RTOG 95-06: phase I/II trial of transurethral surgery plus radiation therapy with concurrent cisplatin and 5-fluorouracil followed by selective bladder preservation or cystectomy depending on the initial response. Oncologist 2000; 5:471–476.
Hagan MP, Winter KA, Kaufman DS, et al. RTOG 97-06: initial report of a phase I-II trial of selective bladder conservation using TURBT, twice-daily accelerated irradiation sensitized with cisplatin, and adjuvant MCV combination chemotherapy. Int J Radiat Oncol Biol Phys 2003; 57:665–672.
Kaufman DS, Winter KA, Shipley WU, et al. Phase I-II RTOG study (99-06) of patients with muscle-invasive bladder cancer undergoing transurethral surgery, paclitaxel, cisplatin, and twice-daily radiotherapy followed by selective bladder preservation or radical cystectomy and adjuvant chemotherapy. Urology 2009; 73:833–837.
Mitin T, Hunt D, Shipley WU, et al. Transurethral surgery and twice-daily radiation plus paclitaxel-cisplatin or fluorouracil-cisplatin with selective bladder preservation and adjuvant chemotherapy for patients with muscle invasive bladder cancer (RTOG 0233): a randomised multicentre phase 2 trial. Lancet Oncol 2013; 14:863–872.
Coen JJ, Zhang P, Saylor PJ, et al. Bladder preservation with twice-a-day radiation plus fluorouracil/cisplatin or once daily radiation plus gemcitabine for muscle-invasive bladder cancer: NRG/RTOG 0712-a randomized phase II trial. J Clin Oncol 2019; 37:44–51.
James ND, Hussain SA, Hall E, et al. BC2001 Investigators Radiotherapy with or without chemotherapy in muscle-invasive bladder cancer. N Engl J Med 2012; 366:1477–1488.
Haque W, Verma V, Butler EB, Teh BS. Chemotherapy versus chemoradiation for node-positive bladder cancer: practice patterns and outcomes from the national cancer data base. Bladder Cancer 2017; 3:283–291.
Swinton M, Mariam NBG, Tan JL, et al. Bladder-sparing treatment with radical dose radiotherapy is an effective alternative to radical cystectomy in patients with clinically node-positive nonmetastatic bladder cancer. J Clin Oncol 2023; 41:4406–4415.
Phase II Study of Bladder-SparIng ChemoradiatioN With Durvalumab in Clinical Stage III, Node PosItive BladdeR CancEr (INSPIRE) [Internet]. 2019. Available at: https://clinicaltrials.gov/study/NCT04216290. [Accessed 1 August 2024].
Powles T, Valderrama BP, Gupta S, et al. EV-302 Trial Investigators Enfortumab vedotin and pembrolizumab in untreated advanced urothelial cancer. N Engl J Med 2024; 390:875–888.
Enfortumab Vedotin in Combination With Pembrolizumab for Locally Advanced and/or Node Positive Urothelial Carcinoma Prior to Surgery (EV-ECLIPSE) [Internet]. 2022. Available at: https://clinicaltrials.gov/study/NCT05239624. [Accessed 1 August 2024].
van der Heijden MS, Sonpavde G, Powles T, et al. CheckMate 901 Trial Investigators Nivolumab plus gemcitabine-cisplatin in advanced urothelial carcinoma. N Engl J Med 2023; 389:1778–1789.
Galsky MD, Sonpavde GP, Powles T, et al. Characterization of complete responders to nivolumab + gemcitabine-cisplatin vs gemcitabine-cisplatin alone and patients with lymph node–only metastatic urothelial carcinoma from the CheckMate 901 trial. J Clin Oncol 2024; 42: (16 Suppl): 4509.
Ben-David R, Tillu N, Cumarasamy S, et al. Longitudinal tumor-informed circulating tumor dna status predicts disease upstaging and poor prognosis for patients undergoing radical cystectomy. Eur Urol Oncol 2024.
Christensen E, Birkenkamp-Demtroder K, Sethi H, et al. Early detection of metastatic relapse and monitoring of therapeutic efficacy by ultra-deep sequencing of plasma cell-free DNA in patients with urothelial bladder carcinoma. J Clin Oncol 2019; 37:1547–1557.
Powles T, Assaf ZJ, Davarpanah N, et al. ctDNA guiding adjuvant immunotherapy in urothelial carcinoma. Nature 2021; 595:432–437.
Durvalumab and Standard Chemotherapy for the Treatment of Lymph Node Positive Bladder Cancer [Internet]. 2021. Available at: https://clinicaltrials.gov/study/NCT05137262. [Accessed 1 August 2024].
A Phase 2, Two-arm Multicenter, Open-Label Study to Determine the Efficacy and the Safety of Two Different Dose Regimens of a Pan-FGFR Tyrosine Kinase Inhibitor JNJ-42756493 in Subjects With Metastatic or Surgically Unresectable Urothelial Cancer With FGFR Genomic Alterations [Internet]. 2015. Available at: https://clinicaltrials.gov/study/NCT02365597. [Accessed 1 August 2024].
A Randomized Phase 3 Study Evaluating Cystectomy With Perioperative Pembrolizumab and Cystectomy With Perioperative Enfortumab Vedotin and Pembrolizumab Versus Cystectomy Alone in Participants Who Are Cisplatin-Ineligible or Decline Cisplatin With Muscle-Invasive Bladder Cancer (KEYNOTE-905/EV-303) [Internet]. 2019. Available at: https://clinicaltrials.gov/study/NCT03924895. [Accessed 1 August 2024].
A Phase 3, Randomized, Double-blind Study to Evaluate Perioperative Pembrolizumab (MK-3475) + Neoadjuvant Chemotherapy Versus Perioperative Placebo + Neoadjuvant Chemotherapy in Cisplatin-eligible Participants With Muscle-invasive Bladder Cancer (KEYNOTE-866) [Internet]. 2019. Available at: https://clinicaltrials.gov/study/NCT03924856. [Accessed 1 August 2024].
Phase III Randomized Adjuvant Study of Pembrolizumab in muScle invaSive and locAlly aDvanced urOthelial caRcinoma (AMBASSADOR) Versus Observation [Internet]. 2017. Available at: https://clinicaltrials.gov/study/NCT03244384. [Accessed 1 August 2024].
A Study of Enfortumab Vedotin (ASG-22CE) as Monotherapy or in Combination With Other Anticancer Therapies for the Treatment of Urothelial Cancer [Internet]. 2017. Available at: https://clinicaltrials.gov/study/NCT03288545. [Accessed 1 August 2024].
A Phase 3 Randomized, Double-blind, Multicenter Study of Adjuvant Nivolumab Versus Placebo in Subjects With High Risk Invasive Urothelial Carcinoma (CheckMate 274: CHECKpoint Pathway and nivoluMAb Clinical Trial Evaluation 274) [Internet]. 2015. Available at: https://clinicaltrials.gov/study/NCT02632409. [Accessed 1 August 2024].