Objective To compare the clinical outcomes of neoadjuvant versus adjuvant chemotherapy on muscle-invasive bladder cancer patients.

Methods We retrospectively reviewed the muscle-invasive bladder cancer patients who were treated with radical cystectomy plus neoadjuvant or adjuvant chemotherapy from 2009 to 2016 in Hubei Cancer Hospital. The primary endpoint was recurrence-free survival (RFS). The secondary endpoint was clinical complete response (CR).

Results A total of 38 muscle-invasive bladder cancer patients were included: 22 patients received neoadjuvant chemotherapy and 16 patients received adjuvant chemotherapy. The RFS at median follow-up time was not significantly different between neoadjuvant and adjuvant groups (69.6% vs. 75.4%, P=0.223). The RFS at median follow-up time between maid patients with pT0 and non-pT0 were significantly different (100% vs. 50%, P=0.012). The incidence rates of grade 3 or 4 thrombocytopenia, anemia and neutropenia were not significantly different between the two groups (P=0.36).

Conclusion There is no significant difference in RFS between neoadjuvant and adjuvant chemotherapy for muscle-invasive bladder cancer patients treated with radical cystectomy. No recurrence occurs in the patients who achieve pT0 in neoadjuvant chemotherapy group. Further investigations are needed to confirm our results.