{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T16:24:50Z","timestamp":1761755090459,"version":"build-2065373602"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the impact of incorporating neoadjuvant chemotherapy (NAC) into the \u2018quadrifecta\u2019 outcomes composite for reporting outcomes of radical cystectomy (RC) creating a pentafecta score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>This is a retrospective multicentre analysis of patients treated with RC, with or without NAC, for bladder cancer between 2002 and 2023. The primary outcome was the effect of adding NAC to a quadrifecta outcomes composite on cancer\u2010specific (CSS) and overall survival (OS). The quadrifecta outcomes composite included a yield of \u226516 lymph nodes, negative soft tissue surgical margin, absence of major complication within 30\u2009days from surgery, and no delay in RC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 590 patients were included in the analyses. A total of 233 (39.5%) patients achieved all quadrifecta outcomes and 82 (13.9%) patients were additionally treated with NAC, achieving the pentafecta. Achieving the quadrifecta outcomes composite was significantly associated with better CSS (hazard ratio [HR] 0.49, 95% confidence interval [CI] 0.32\u20130.75;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001) and OS (HR 0.48, 95% CI 0.34\u20130.69;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01). The addition of NAC to the quadrifecta composite outcomes significantly improved the discrimination of patients more likely to have better CSS (HR 0.21, 95% CI 0.08\u20130.57;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002) and OS (HR 0.26, 95% CI 0.12\u20130.55;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We propose a new pentafecta that may serve as a tool for standardising outcomes reporting and measuring the quality of RC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16331","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T08:52:31Z","timestamp":1710406351000},"page":"459-464","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Addition of neoadjuvant chemotherapy to a \u2018quadrifecta\u2019 composite in radical cystectomy"],"prefix":"10.1111","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1625-1077","authenticated-orcid":false,"given":"David","family":"D\u2019Andrea","sequence":"first","affiliation":[{"name":"Department of Urology Medical University of Vienna  Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8443-8453","authenticated-orcid":false,"given":"Francesco","family":"Soria","sequence":"additional","affiliation":[{"name":"Department of Urology, AOU Citt\u00e0 della Salute e della Scienza Torino School of Medicine  Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3084-2458","authenticated-orcid":false,"given":"Marco","family":"Moschini","sequence":"additional","affiliation":[{"name":"Department of Urology IRCCS Ospedale San Raffaele and Vita\u2010Salute San Raffaele University  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8953-0272","authenticated-orcid":false,"given":"Ekaterina","family":"Laukhtina","sequence":"additional","affiliation":[{"name":"Department of Urology Medical University of Vienna  Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodolfo","family":"Hurle","sequence":"additional","affiliation":[{"name":"Department of Urology IRCCS Humanitas Clinical and Research Hospital  Rozzano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Mancon","sequence":"additional","affiliation":[{"name":"Department of Urology Medical University of Vienna  Vienna Austria"},{"name":"Department of Urology IRCCS Humanitas Clinical and Research Hospital  Rozzano Italy"},{"name":"Department of Biomedical Sciences Humanitas University  Pieve Emanuele Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7455-8803","authenticated-orcid":false,"given":"Alessandro","family":"Antonelli","sequence":"additional","affiliation":[{"name":"UOC Urologia Azienda Ospedaliera Universitaria Integrata Di Verona  Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9361-2342","authenticated-orcid":false,"given":"Jeremy Yuen\u2010Chun","family":"Teoh","sequence":"additional","affiliation":[{"name":"Department of Surgery, S.H. Ho Urology Centre, Prince of Wales Hospital The Chinese University of Hong Kong  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahrokh F.","family":"Shariat","sequence":"additional","affiliation":[{"name":"Department of Urology Medical University of Vienna  Vienna Austria"},{"name":"Department of Urology University of Texas Southwestern Medical Center  Dallas TX USA"},{"name":"Departments of Urology Weill Cornell Medical College  New York NY USA"},{"name":"Department of Urology, Second Faculty of Medicine Charles University  Prague Czech Republic"},{"name":"Department of Urology University of Jordan  Amman Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Pradere","sequence":"additional","affiliation":[{"name":"Department of Urology Croix Du Sud Hospital  Quint\u2010Fonsegrives France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2021.09.026"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002190"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-019-02769-9"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2018.11.002"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15178"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-021-03753-y"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15890"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.14861"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2015-0440"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15253"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25011"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-015-1572-x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2018.09.047"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2009.01.004"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.07.046"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-410x.2000.00614.x"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2010.02.021"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2012.11664.x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2019.09.008"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2018.09.004"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2015.11.006"}],"container-title":["BJU International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bju.16331","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T16:20:52Z","timestamp":1761754852000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/10.1111\/bju.16331"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,14]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["10.1111\/bju.16331"],"URL":"https:\/\/doi.org\/10.1111\/bju.16331","archive":["Portico"],"relation":{},"ISSN":["1464-4096","1464-410X"],"issn-type":[{"type":"print","value":"1464-4096"},{"type":"electronic","value":"1464-410X"}],"subject":[],"published":{"date-parts":[[2024,3,14]]},"assertion":[{"value":"2024-03-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}