Adjuvant Chemotherapy Is Possibly Beneficial for  Locally Advanced or Node-Positive XXXX .

@entity1 @entity900 @entity150 @entity3 @entity1349
BACKGROUND: This study aimed to evaluate the outcomes of @entity900 -based adjuvant chemotherapy (AC) after radical cystectomy (RC) in non-organ-confined @entity150 . METHODS: Sixty-one @entity1 who did not receive neoadjuvant chemotherapy (NAC) underwent RC for locally advanced (pT3-4) or node-positive (pN1-3) @entity150 , or both, between 1990 and 2012. Of these @entity1 , 39 (64%) received @entity900 -based AC after RC (AC group) and the remaining 22 @entity1 (36%) did not (non-AC group). Cancer-specific survival (CSS) and @entity1349 ( @entity1349 ) were compared between the groups. RESULTS: The AC group was significantly younger (P  = .004), but no significant differences were noted between the groups for pT stage, pN stage, nuclear grade, renal function, and salvage chemotherapy rates after recurrence. During a follow-up of 29 months (median), 40 @entity1 (67%) experienced recurrence/ @entity3 and 34 (56%) died of recurrent @entity150 . The AC group showed better @entity1349 than the non-AC group, but the difference was not statistically significant ( @entity1349 [ @entity1349 ], 23.7 vs. 11.4 months, respectively; P  = .154). CSS was significantly better for the AC group than for the non-AC group ( @entity1349 , 57.4 vs. 17.9 months, respectively; P  = .008). On multivariate analysis, AC was an independent predictive factor for both @entity1349 (hazard ratio [HR], 0.325; P  = .005) and CSS (HR, 0.186; P  < .001), along with surgical margin status and lymphovascular invasion (LVI). In a subgroup analysis of 31 node-positive cases, the AC group had a significantly better CSS compared with the non-AC group (P  = .029). Analysis of node-negative cases (n  = 30) yielded no significant benefit for AC. CONCLUSION: Our observations suggest that postoperative @entity900 -based AC improves survival in locally advanced or node-positive @entity150 , especially in node-positive cases.
