The Absolute Effect / Evidence / SWOG 8710
Bladder Cancer · Medical Oncology · Neoadjuvant
SWOG 8710
Clinical question
Does neoadjuvant cisplatin-based chemotherapy improve survival before cystectomy in muscle-invasive bladder cancer?
Trial context
Population
307 evaluable patients with T2–T4a N0 M0 muscle-invasive bladder cancer
Intervention
Neoadjuvant MVAC + radical cystectomy vs radical cystectomy alone
Key endpoint
5-year overall survival
Time horizon / follow-up
Median follow-up about 8.5 years
Absolute Effect
What changes for patients?
Neoadjuvant MVAC increased 5-year OS from 43% to 57%, an absolute benefit of 14 percentage points (NNT 8), with median OS 77 vs 46 months. Pathologic complete response was 38% vs 15%. NNT is based on 5-year overall survival.
NNT: 8
Treatment burden / harm
Chemotherapy treatment burden
NNH: Not quantifiable from the long-term publication; acute MVAC toxicity should be reported in text
Relative effect
HR: Death HR about 0.67
5-year OS P=.06; median OS 77 vs 46 months
Clinical interpretation
SWOG 8710 established that neoadjuvant MVAC before cystectomy improves survival for cisplatin-eligible MIBC, providing a foundation for modern perioperative systemic therapy.
Primary publication
- Grossman HB, et al. N Engl J Med. 2003;349:859–866.
- Primary publication / source