Perioperative Systemic Treatment Patterns and Postoperative Mortality Among Patients With Muscle-Invasive…

ObservationalInternational journal of urology : official journal of the Japanese Urological Association· Jul 2026

Perioperative Systemic Treatment Patterns and Postoperative Mortality Among Patients With Muscle-Invasive Bladder Cancer Undergoing Radical Cystectomy in Japan: WAKKA-MIBC Study.

Eiji Kikuchi, Jumpei Tokumaru, Daisuke Kawai … Junichi Inokuchi

Bladder & Upper TractObservationalClinical practiceQ2IF 1.8

30-day mortality after cystectomy stayed very low despite rising neoadjuvant chemotherapy use.

Perioperative Systemic Treatment Patterns and Postoperative Mortality Among Patients With Muscle-Invasive Bladder Cancer Undergoing Radical Cystectomy in Japan: WAKKA-MIBC Study.

Eiji Kikuchi … Junichi Inokuchi

International journal of urology · Jul 2026 · Q2 in Urology

Purpose

To characterize the temporal changes in perioperative systemic treatment patterns and postoperative mortality among Japanese patients with stage II-III muscle-invasive bladder cancer (muscle-invasive bladder cancer) undergoing radical cystectomy (radical cystectomy) from 2013 to 2024.

Methods

This retrospective observational cohort study assessed neoadjuvant chemotherapy (neoadjuvant chemotherapy) and adjuvant therapy (adjuvant therapy) relative to radical cystectomy.

n = 208 patients

Results

deaths after surgery with chemo first stayed just as low

More results

Among 5 208 patients, the use of neoadjuvant chemotherapy + radical cystectomy increased from 31.4% in 2013-2017 to 50.4% in 2022-2024, and the use of neoadjuvant chemotherapy + radical cystectomy + adjuvant therapy increased from 8.7% to 22.4%.

Radical cystectomy alone decreased from 46.3% to 21.4%.

More results

Reduced-dose gemcitabine + cisplatin (GC) and gemcitabine + carboplatin were frequently used and remained common throughout the study period.

In 2022-2024, 18.8% of patients received adjuvant nivolumab; most had received neoadjuvant chemotherapy beforehand (242/270).

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Conclusion · 1 of 2

Perioperative systemic therapy for muscle-invasive bladder cancer in Japan has intensified over the past decade, with increased adoption of neoadjuvant chemotherapy and adjuvant nivolumab.

Conclusion · 2 of 2

Dose-modified GC and carboplatin-based regimens have remained commonly used throughout the study period. Even with increased neoadjuvant chemotherapy use, postoperative mortality has remained low.

Perioperative Systemic Treatment Patterns and Postoperative Mortality Among Patients With Muscle-Invasive Bladder Cancer Undergoing Radical Cystectomy in Japan: WAKKA-MIBC Study.

Perioperative Systemic Treatment Patterns and Postoperative Mortality Among Patients With Muscle-Invasive Bladder Cancer Undergoing Radical Cystectomy in Japan: WAKKA-MIBC Study.

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