Computed tomography (CT) following neoadjuvant chemotherapy (NAC) for muscle-invasive bladder cancer does not predict disease burden prior to radical cystectomy, according to study finding presented at the Society of Urologic Oncology 22nd annual meeting.
The study, by Syed M. Alam, MD, of the University of Kansas Health System in Kansas City, and colleagues, included 141 patients, of whom 111 (78.7%) had pre-NAC CT scans available for comparison. Pathologic complete response (PCR) and pathologic partial response (PPR) were achieved in 33.5% and 16.0% of patients, respectively.
The investigators defined PCR as pT0N0 and PPR as pTa, pT1, or pTis disease at radical cystectomy.
Post-NAC CT scans correlated poorly with final pathology at radical cystectomy, according to investigators. Radiographic complete response on post-NAC CT (no features of bladder cancer present) had a positive predictive value (PPV) and negative predictive value (NPV) of 29.3% and 73.5% for PCR, respectively. Radiographic partial response on post-NAC CT (decrease in tumor size or number or resolution of lymphadenectomy or cT3 features) had a PPV and NPV of 38.4% and 49.2%, respectively.
Alam SM, Martin A, Thompson J, et al. Computed tomography following neoadjuvant chemotherapy does not predict disease burden prior to radical cystectomy. Presented at the 22nd annual meeting of the Society of Urologic Oncology, December 1-3, 2021. Poster 237.