Annals of surgical oncology · 2025
Cancer-Specific Mortality of Partial Cystectomy Versus Radical Cystectomy in T2N0M0 Urothelial Bladder Cancer.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Longoni Mattia, Marmiroli Andrea, Falkenbach Fabian, Le Quynh Chi, Nicolazzini Michele, Catanzaro Calogero, Polverino Federico, Tian Zhe, Goyal Jordan A, Ferro Matteo, Graefen Markus, Chun Felix K H, Volpe Alessandro, Schiavina Riccardo, Longo Nicola, Saad Fred, Shariat Shahrokh F, Moschini Marco, Gandaglia Giorgio, Montorsi Francesco, Briganti Alberto, Karakiewicz Pierre I
Аннотация
BACKGROUND: The authors hypothesized that for T2N0M0 urothelial carcinoma of urinary bladder (UCUB) patients, partial cystectomy (PC) does not differ from radical cystectomy (RC) regarding cancer-specific mortality (CSM).
METHODS: Within the Surveillance, Epidemiology and End Results (SEER) database (2004-2021), rates of PC versus RC for T2N0M0 UCUB patients were tabulated. Nearest-neighbor 1:1 propensity score-matching (PSM) for age, sex, tumor size and site, race/ethnicity, chemotherapy, and pelvic lymph node dissection status was applied. Poisson-smoothed cumulative incidence plots depicted 5-year CSM and other-cause mortality (OCM) rates. Uni- and multivariable competing-risks regression (CRR) models were fitted. Sensitivity analyses were performed for patients with tumors ≤ 3 cm, tumors amenable to segmental resection (outside trigone, ureteric orifices, or bladder neck), or both.
RESULTS: Of 5425 T2N0M0 UCUB patients, 412 (7.6%) received PC versus 5013 (92.4%) who received RC. The PC rates decreased from 12.1% in 2004 to 6.2% in 2021 (p < 0.001). After PSM, the 5 year CSM rate was 26.7% for PC versus 28.4% for RC, and after ultivariable CRR, PC was unrelated to CSM rates (multivariable hazard ratio [mHR], 0.9; p = 0.2). In separate sensitivity analyses of 3187 (58.7%) patients with tumors ≤ 3 cm, 2521 (46.5%), patients with tumors amenable to segmental resection, and 1416 (26.1%) patients with both, after reapplication of PSM and additional multivariable adjustment, virtually the same results were observed.
CONCLUSION: A small proportion of T2N0M0 UCUB patients underwent PC instead of RC. However, for well-selected patients, PC was not associated with worse cancer control outcomes than RC.
METHODS: Within the Surveillance, Epidemiology and End Results (SEER) database (2004-2021), rates of PC versus RC for T2N0M0 UCUB patients were tabulated. Nearest-neighbor 1:1 propensity score-matching (PSM) for age, sex, tumor size and site, race/ethnicity, chemotherapy, and pelvic lymph node dissection status was applied. Poisson-smoothed cumulative incidence plots depicted 5-year CSM and other-cause mortality (OCM) rates. Uni- and multivariable competing-risks regression (CRR) models were fitted. Sensitivity analyses were performed for patients with tumors ≤ 3 cm, tumors amenable to segmental resection (outside trigone, ureteric orifices, or bladder neck), or both.
RESULTS: Of 5425 T2N0M0 UCUB patients, 412 (7.6%) received PC versus 5013 (92.4%) who received RC. The PC rates decreased from 12.1% in 2004 to 6.2% in 2021 (p < 0.001). After PSM, the 5 year CSM rate was 26.7% for PC versus 28.4% for RC, and after ultivariable CRR, PC was unrelated to CSM rates (multivariable hazard ratio [mHR], 0.9; p = 0.2). In separate sensitivity analyses of 3187 (58.7%) patients with tumors ≤ 3 cm, 2521 (46.5%), patients with tumors amenable to segmental resection, and 1416 (26.1%) patients with both, after reapplication of PSM and additional multivariable adjustment, virtually the same results were observed.
CONCLUSION: A small proportion of T2N0M0 UCUB patients underwent PC instead of RC. However, for well-selected patients, PC was not associated with worse cancer control outcomes than RC.