Grossman - Figure 21
Neoadjuvant Chemotherapy Delays Cystectomy Thereby Increasing Risk
FIG. 21: Another argument against neoadjuvant chemotherapy is that it delays cystectomy thereby increasing risk. This study from the University of Michigan[8]
examined 153 patients. Median time to cystectomy from the first day of chemotherapy was 16.6 weeks. Median time to cystectomy from the last day of chemotherapy was 6.9 weeks. The most common cause of delay beyond 10 weeks after chemotherapy was not toxicity, but scheduling, ie, finding time to get patients into the operating room schedule. Timing of cystectomy did not alter the risk of survival, either for cancer-specific or overall survival.
References
Alva AS, Tallman CT, He C, et al. Efficient delivery of radical cystectomy after neoadjuvant chemotherapy for muscle-invasive bladder cancer: a multidisciplinary approach. 2012;118:44−53 https://doi.org/10.1002/cncr.26240
