Abstract
Background: Bladder cancer is the most common malignancy involving the urinary system and the tenth most common malignancy worldwide. Bladder cancer is the fourth most common cancer and the fifth most leading cause of cancer death in Egypt. This study aimed to assess all patients’ molecular subtypes (basal & luminal) of muscle-invasive bladder cancer and its impact on response to neoadjuvant chemotherapy and survival.
Methods: This retrospective study was carried out on 70 patients with muscle-invasive bladder cancer (MIBC) stage II and III for two years.
Results: There were no statistically significant differences between the three studied groups regarding the type of pathology. Most of the patients were urothelial carcinoma. There was a significant difference regarding grading. There were statistically significant differences between the three groups regarding T tumor size. There were no statistically significant differences between the three studied groups regarding N lymph nodes & staging, multiplicity & site of the tumor, response to NAC. Regarding the response to CCRTh, there were significant statistically differences between the three studied groups. There was a significant increase in response in luminal subtype & non-basal-non-luminal compared with basal subtype, which showed a worse response.
Conclusions: Different molecular subtypes are established in bladder cancers that have distinct sensitivity to neoadjuvant chemotherapy. Cisplatin-based neoadjuvant chemotherapy is a significant issue in managing muscle-invasive bladder cancers (MIBC). However, the association between pathologic response to NAC and molecular subtypes is not strong enough to warrant exemption from chemotherapy.
Keywords
Muscle-invasive bladder cancer, Molecular subtypes, Neoadjuvant chemotherapy