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Association of age with response to preoperative chemotherapy in patients with muscle-invasive bladder cancer
D. D'Andrea, PC. Black, H. Zargar, K. Zargar-Shoshtari, F. Soria, AS. Fairey, LS. Mertens, CP. Dinney, MC. Mir, LM. Krabbe, MS. Cookson, NE. Jacobsen, JS. Montgomery, N. Vasdev, EY. Yu, E. Xylinas, NJ. Campain, W. Kassouf, MA. Dall'Era, JA. Seah,...
Language English Country Germany
Document type Journal Article, Multicenter Study
- MeSH
- Adult MeSH
- Neoplasm Invasiveness MeSH
- Combined Modality Therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Urinary Bladder Neoplasms drug therapy pathology surgery MeSH
- Preoperative Period MeSH
- Retrospective Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Age Factors MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
PURPOSE: To assess the association of patient age with response to preoperative chemotherapy in patients with muscle-invasive bladder cancer (MIBC). MATERIALS AND METHODS: We analyzed data from 1105 patients with MIBC. Patients age was evaluated as continuous variable and stratified in quartiles. Pathologic objective response (pOR; ypT0-Ta-Tis-T1N0) and pathologic complete response (pCR; ypT0N0), as well survival outcomes were assessed. We used data of 395 patients from The Cancer Genome Atlas (TCGA) to investigate the prevalence of TCGA molecular subtypes and DNA damage repair (DDR) gene alterations according to patient age. RESULTS: pOR was achieved in 40% of patients. There was no difference in distribution of pOR or pCR between age quartiles. On univariable logistic regression analysis, patient age was not associated with pOR or pCR when evaluated as continuous variables or stratified in quartiles (all p > 0.3). Median follow-up was 18 months (IQR 6-37). On Cox regression and competing risk regression analyses, age was not associated with survival outcomes (all p > 0.05). In the TCGA cohort, patient with age ≤ 60 years has 7% less DDR gene mutations (p = 0.59). We found higher age distribution in patients with luminal (p < 0.001) and luminal infiltrated (p = 0.002) compared to those with luminal papillary subtype. CONCLUSIONS: While younger patients may have less mutational tumor burden, our analysis failed to show an association of age with response to preoperative chemotherapy or survival outcomes. Therefore, the use of preoperative chemotherapy should be considered regardless of patient age.
Bristol Urological Institute North Bristol NHS Trust Bristol UK
Cross Cancer Institute Edmonton AB Canada
Department of Genitourinary Oncology H Lee Moffitt Cancer Center and Research Institute Tampa FL USA
Department of Oncology University of Alberta Edmonton AB Canada
Department of Surgery McGill University Health Center Montreal Canada
Department of Urologic Sciences University of British Columbia Vancouver BC Canada
Department of Urologic Surgery Vanderbilt University Medical Center Nashville TN USA
Department of Urology 2nd Faculty of Medicine Charles University Prag Czech Republic
Department of Urology Davis Medical Center University of California At Davis Sacramento CA USA
Department of Urology Freeman Hospital Newcastle Upon Tyne UK
Department of Urology Fundacion Instituto Valenciano de Oncologia Valencia Spain
Department of Urology MD Anderson Cancer Center Houston TX USA
Department of Urology Molinette Hospital University of Turin Turin Italy
Department of Urology Stanford University School of Medicine Stanford CA USA
Department of Urology University of Kansas Medical Center Kansas City KS USA
Department of Urology University of Michigan Health System Ann Arbor MI USA
Department of Urology University of Münster Münster Germany
Department of Urology University of Oklahoma College of Medicine Oklahoma City OK USA
Department of Urology University of Texas Southwestern Medical Center Dallas TX USA
Department of Urology University of Washington Seattle WA USA
Department of Urology Western Health Melbourne Australia
Departments of Urology Weill Cornell Medical College New York NY USA
Glickman Urological and Kidney Institute Cleveland Clinic Cleveland OH USA
Princess Margaret Hospital Toronto ON Canada
University of Alberta Edmonton AB Canada
References provided by Crossref.org
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- $a D'Andrea, David $u Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
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- $a Association of age with response to preoperative chemotherapy in patients with muscle-invasive bladder cancer / $c D. D'Andrea, PC. Black, H. Zargar, K. Zargar-Shoshtari, F. Soria, AS. Fairey, LS. Mertens, CP. Dinney, MC. Mir, LM. Krabbe, MS. Cookson, NE. Jacobsen, JS. Montgomery, N. Vasdev, EY. Yu, E. Xylinas, NJ. Campain, W. Kassouf, MA. Dall'Era, JA. Seah, CE. Ercole, S. Horenblas, SS. Sridhar, JS. McGrath, J. Aning, JL. Wright, AC. Thorpe, TM. Morgan, JM. Holzbeierlein, TJ. Bivalacqua, S. North, DA. Barocas, Y. Lotan, P. Grivas, AJ. Stephenson, JB. Shah, BW. van Rhijn, S. Daneshmand, PE. Spiess, SF. Shariat
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- $a PURPOSE: To assess the association of patient age with response to preoperative chemotherapy in patients with muscle-invasive bladder cancer (MIBC). MATERIALS AND METHODS: We analyzed data from 1105 patients with MIBC. Patients age was evaluated as continuous variable and stratified in quartiles. Pathologic objective response (pOR; ypT0-Ta-Tis-T1N0) and pathologic complete response (pCR; ypT0N0), as well survival outcomes were assessed. We used data of 395 patients from The Cancer Genome Atlas (TCGA) to investigate the prevalence of TCGA molecular subtypes and DNA damage repair (DDR) gene alterations according to patient age. RESULTS: pOR was achieved in 40% of patients. There was no difference in distribution of pOR or pCR between age quartiles. On univariable logistic regression analysis, patient age was not associated with pOR or pCR when evaluated as continuous variables or stratified in quartiles (all p > 0.3). Median follow-up was 18 months (IQR 6-37). On Cox regression and competing risk regression analyses, age was not associated with survival outcomes (all p > 0.05). In the TCGA cohort, patient with age ≤ 60 years has 7% less DDR gene mutations (p = 0.59). We found higher age distribution in patients with luminal (p < 0.001) and luminal infiltrated (p = 0.002) compared to those with luminal papillary subtype. CONCLUSIONS: While younger patients may have less mutational tumor burden, our analysis failed to show an association of age with response to preoperative chemotherapy or survival outcomes. Therefore, the use of preoperative chemotherapy should be considered regardless of patient age.
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