The effect of radical cystectomy on survival in patients with metastatic urothelial carcinoma of the urinary bladder
Language English Country United States Media print-electronic
Document type Comparative Study, Journal Article
PubMed
31562831
DOI
10.1002/jso.25717
Knihovny.cz E-resources
- Keywords
- chemotherapy, metastatic urothelial carcinoma of the urinary bladder, radical cystectomy,
- MeSH
- Cystectomy mortality MeSH
- Carcinoma, Transitional Cell drug therapy mortality pathology surgery MeSH
- Combined Modality Therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Survival Rate MeSH
- Urinary Bladder Neoplasms drug therapy mortality pathology surgery MeSH
- Follow-Up Studies MeSH
- Prognosis MeSH
- SEER Program MeSH
- Antineoplastic Combined Chemotherapy Protocols therapeutic use MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Comparative Study 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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