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Master Thesis

Impact de la chimiothérapie néo adjuvante sur la morbidité péri opératoire de la cystectomie pour tumeur de vessie infiltrant le muscle

Abstract : Introduction: platinum-based Neo Adjuvant Chemotherapy (NAC) before Radical Cystectomy (RC) is the gold standard in the treatment of Muscle Invasive Bladder Cancer (MIBC). We aimed to compare the peri operative morbidity in patients treated by NAC then RC and patients having RC alone. Methods: between January 1st, 2008 and December 31st, 2015, we retrospectively included consecutive patients performing RC for MIBC in 2 centres. We collected clinical, pathological and peri operative data (30-day post operative complications according to the Clavien-Dindo score, delayed complications, pathological results). Patients treated by NAC (NAC-RC group) before RC were compared to patients performing RC alone. The NAC-RC group received 1 to 6 cycle of high-dose MVAC, MVAC or gemcitabine-cisplatine chemotherapy. Logistic regression identified independent factors of peri operative complications. Results: we included 199 patients : 48 in the NAC-RC group and 151 in the RC group. Complications rate was 73.9% in the NAC-RC group versus 73.8% in the RC group (p = 1.0). In multivariate analyses, only the Charlson score was associated with an increased risk of peri operative complications (p=0.05). pT0 tumour rate was significantly higher in the NAC-CR group (50% vs 7%, p< 0.001). Conclusion: NAC does not increase the peri operative morbidity of the RC. Patients’ pre operative comorbidities is the main risk factor for peri operative complications.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01893431
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Submitted on : Thursday, October 11, 2018 - 2:01:32 PM
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Constance Périnet-Marquet Michel. Impact de la chimiothérapie néo adjuvante sur la morbidité péri opératoire de la cystectomie pour tumeur de vessie infiltrant le muscle. Médecine humaine et pathologie. 2018. ⟨dumas-01893431⟩

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