Long-term efficacy of neoadjuvant chemotherapy in myoinvasive urothelial cancer-a retrospective study from the Canberra hospital

Background: The majority of the bladder cancers are myoinvasive at diagnosis, and half of them develop metastatic disease within two years and cause death.1-2 Neoadjuvant therapy lowers recurrence risk by 19% with absolute disease-free survival of 7% and improves overall survival by 13%.3-4 The long-term efficacy of neoadjuvant chemotherapy in myoinvasive bladder cancer is not well established, mainly in the Australian cohort. Our study aims at investigating the disease-free survival and overall survival benefit of neoadjuvant chemotherapy for myoinvasive bladder cancer over 11 years in the Australian cohort. Methods: We conducted a retrospective analysis of the patients who received neoadjuvant chemotherapy for myoinvasive bladder cancer from 2009 to 2020 in the Canberra Hospital and affiliated oncology centres. Disease-free survival and overall survival analysis were calculated using Kaplan-Meier survival analysis. Results: We screened 41 patients who received neoadjuvant chemotherapy. Of 41 patients, one patient died before surgery. Among the study cohort, the median age was 68. Fifty-six percent of patients had ECOG 0. All received neoadjuvant chemotherapy with Cisplatin and Gemcitabine except two patients who had carboplatin instead of Cisplatin.