Grossman - Figure 16
Adding Chemotherapy Improves Survival
FIG. 16: The ABC meta-analysis[5] examined data from 3005 bladder cancer patients, and showed an absolute improvement in 5-year survival of 5%. In breast cancer, a disease where chemotherapy is commonly used with definitive therapy in patients aged <50 years, a European review of polychemotherapy versus no chemotherapy in 28,764 patients reported an absolute improvement in 5-year survival of 5%.[6] In colon cancer in 3302 patients an absolute improvement in 5-year survival of 7% was reported.[7]
So, in breast and colon cancer, these differences are enough to justify the routine use of chemotherapy with definitive treatment. Nevertheless, in bladder cancer, there has been reluctance to add this definitive treatment.
References
Advanced Bladder Cancer (ABC) 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;48:202−5 http://dx.doi.org/10.1016/j.eururo.2005.04.006
Early Breast Cancer Trialists Collaborative Group (EBCTC). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. 2005 ;365:1687−717 https://doi.org/10.1016/S0140-6736(05)66544-0
Gill S, Loprinzi CL, Sargent DJ, et al. Pooled analysis of fluorouracil-based adjuvant therapy for stage II and III colon cancer: who benefits and by how much? J Clin Oncol. 2004;22:1797−806 https://doi.org/10.1200/JCO.2004.09.059
