Grossman - Figure 10
MVAC + Cystectomy vs Cystectomy Alone
FIG. 10: Achieving pT0 is important for outcome, as shown in SWOG 8710[2] and in multiple subsequent study reports. In patients randomized to surgery alone in SWOG 8710, 15% achieved pT0 because all of the tumor was resected before going to cystectomy. In patients randomized to neoadjuvant MVAC plus cystectomy, the pT0 rate was more than doubled to 38% (highly statistically significant, P=0.001).
Mortality risk in the patients randomized to surgery was 33% higher than those randomized to neoadjuvant chemotherapy; the disease-specific risk for those randomized to surgery was 66% greater than for those randomized to neoadjuvant chemotherapy.
References
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;349:859−66 https://doi.org/10.1056/NEJMoa022148
