The effect of radical cystectomy on survival in patients with metastatic urothelial carcinoma of the urinary bladder
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu srovnávací studie, časopisecké články
PubMed
31562831
DOI
10.1002/jso.25717
Knihovny.cz E-zdroje
- Klíčová slova
- chemotherapy, metastatic urothelial carcinoma of the urinary bladder, radical cystectomy,
- MeSH
- cystektomie mortalita MeSH
- karcinom z přechodných buněk farmakoterapie mortalita patologie chirurgie MeSH
- kombinovaná terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- nádory močového měchýře farmakoterapie mortalita patologie chirurgie MeSH
- následné studie MeSH
- prognóza MeSH
- program SEER MeSH
- protokoly protinádorové kombinované chemoterapie terapeutické užití MeSH
- retrospektivní studie MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
BACKGROUND: To test the effect of radical cystectomy (RC) with chemotherapy vs only chemotherapy on overall mortality (OM) in metastatic urothelial carcinoma of the urinary bladder (mUCUB). METHODS: Within the Surveillance, Epidemiology, and End Results registry (2004-2016), we identified patients with mUCUB. Stratification was made according to treatment: RC with chemotherapy vs only chemotherapy. Kaplan-Meier plots and multivariable Cox regression models were used before and after 1:1 propensity score (PS) matching and inverse probability of treatment weighting (IPTW). RESULTS: Of 2414 patients with mUCUB, 500 (21.0%) vs 1914 (79.0%) were treated with RC with chemotherapy vs only chemotherapy, respectively. In multivariable Cox regression models, RC with chemotherapy was associated with lower OM in the overall cohort (hazard ratio [HR], 0.5; P < .001), after 1:1 PS matching (HR, 0.5; P < .001), after IPTW (HR, 0.5; P < .001) and after accounting for number and location of metastases (HR, 0.5; P < .001). However, higher overall survival after RC with chemotherapy was only observed in patients with one metastatic site (21 vs 16 months; P = .001). CONCLUSION: In contemporary patients with mUCUB, RC with chemotherapy is associated with lower OM rates, relative to chemotherapy alone, but only in patients with a single metastatic site. These individuals accounted for the vast majority of patients in whom an RC was performed, despite the presence of metastatic disease.
Department of Oncology and Hemato Oncology University of Milan Milan Italy
Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria
Department of Urology European Institute of Oncology IRCCS Milan Italy
Department of Urology San Luigi Gonzaga Hospital University of Turin Turin Italy
Department of Urology University Hospital Frankfurt Frankfurt Germany
Department of Urology University of Texas Southwestern Dallas Texas
Departments of Urology Weill Cornell Medical College New York New York
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