Mount Sinai Researchers Find Chemotherapy after Bladder Cancer Surgery Improved Survival
Analysis of More Than 5,000 Patients Presented at 2015 Genitourinary Cancer Symposium
Patients that received chemotherapy after bladder cancer surgery demonstrated an approximately 30% lower risk of death than those that underwent surgery alone, according to an analysis to be presented by researchers at the Icahn School of Medicine at Mount Sinai at the 2015 Genitourinary Cancers Symposium.
Clinical trials have established the benefit of giving chemotherapy prior to surgery (neoadjuvant chemotherapy) for patients with bladder cancer. However, clinical trials exploring giving chemotherapy after surgery (adjuvant chemotherapy) have been difficult to interpret and many of the trials closed early due to poor accrual without providing an answer.
Lead researcher Matthew Galsky, MD and colleagues used a large database of patients diagnosed with cancer in the United States. Specifically, the study found that patients receiving adjuvant chemotherapy after surgical treatment had improved overall survival when compared to patients that received surgical treatment alone with only post-surgical observation.
“Until now, data supporting adjuvant chemotherapy has been mixed,” said lead Dr. Galsky, Associate Professor of Medicine, Hematology and Medical Oncology, and Assistant Professor, Urology at the Icahn School of Medicine at Mount Sinai. “Our analysis of actual cases supports the use of chemotherapy after surgery for patients with locally advanced bladder cancer.”
Of the 5,653 patients analyzed, 1,293 patients received adjuvant chemotherapy versus 4,360 patients who received surgery alone.
“Chemotherapy prior to surgery remains the optimal approach for patients with bladder cancer based on the available evidence. However, population-based observational studies may be used to help fill the knowledge void in situations where clinical trials have not yielded definitive evidence. This comparative effectiveness analysis may help inform the care of patients with bladder cancer who have not received chemotherapy prior to surgery,” Dr. Galsky said.
This study was a collaborative effort by researchers at the Tisch Cancer Institute at Mount Sinai; Departments of Preventative Medicine and Urology at the Icahn School of Medicine at Mount Sinai; and the Lahey Clinic in Burlington, MA.
The findings are included in an abstract featured at the 2015 Genitourinary Cancers Symposium, which is co-sponsored by the American Society of Clinical Oncology, the American Society for Radiation Oncology, and the Society of Urologic Oncology. The Symposium will take place February 26-28 in Orlando.
About the Mount Sinai Health System
The Mount Sinai Health System is New York City's largest integrated delivery system encompassing seven hospital campuses, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai's vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation.
The System includes approximately 7,100 primary and specialty care physicians; 10 joint-venture ambulatory surgery centers; more than 140 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of 3 medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools", aligned with a U.S. News & World Report's "Honor Roll" Hospital, No. 13 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 18 on U.S. News & World Report's "Honor Roll" of top U.S. hospitals; it is one of the nation's top 20 hospitals in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Geriatrics, Nephrology, and Neurology/Neurosurgery, and in the top 50 in four other specialties in the 2017-2018 "Best Hospitals" issue. Mount Sinai's Kravis Children's Hospital also is ranked in six out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 12th nationally for Ophthalmology and 50th for Ear, Nose, and Throat, while Mount Sinai Beth Israel, Mount Sinai St. Luke's and Mount Sinai West are ranked regionally.