Clinical genitourinary cancer · 2025
Trimodality Therapy for Bladder Cancer: A Single Institution Retrospective Analysis of Factors Associated With Outcomes for High-Risk Patients Undergoing Organ-Sparing Therapy.
СтатьяНазвание 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.
Nair Monica S, Scarborough Jessica, Reddy Chandana A, Bommireddy Anirudh R, Brooks Erin, Almassi Nima, Weight Christopher J, Campbell Steven, Ornstein Moshe C, Nizam Amanda, Gilligan Timothy, Wee Christopher, Gupta Shilpa, Scott Jacob G, Mastroianni Anthony, Tendulkar Rahul, Mian Omar Y
Аннотация
PURPOSE: We sought to define patient and disease characteristics associated with outcomes after trimodality therapy (TMT) for high-risk nonmuscle invasive and muscle invasive bladder cancer (MIBC). A retrospective analysis of a large single institution cohort treated with bladder preservation therapy was performed to identify factors associated with survival.
METHODS AND MATERIALS: Patients with high-risk non-MIBC or MIBC who underwent definitive bladder sparing treatment between 2006 and 2022 were included. Variables for analysis included age, sex, Charlson Comorbidity Index (CCI), surgical candidacy, neoadjuvant/induction chemotherapy (NAC), tumor size, presence of hydronephrosis, carcinoma in-situ, and histologic subtype. Kaplan-Meier analysis was done to calculate rates of overall survival (OS) and disease-free survival (DFS), while cumulative incidence analysis was done to calculate rates of cancer specific mortality (CSM) and local recurrence. Cox proportional hazards regression was done to identify factors associated with OS and DFS. Competing risk regression was done to identify factors associated with CSM and local recurrence.
RESULTS: 226 patients were included in the cohort with a median follow up of 18.9 months (range 0.9-172.3). The median age was 79 years (range 49-98) and 79.2% were male. On univariate Cox proportional hazards regression, younger age, NAC, and cystectomy candidacy were associated with improved OS (P < .0001, HR = 1.05, 95% CI, 1.03-1.08; P = .04, HR = 0.62, 95% CI, 0.39-0.99; P < .0001, HR = 0.42, 95% CI, 0.27-0.65; respectively). On multivariable analysis, only younger age and cystectomy eligibility were associated with improved OS (P = .002, HR = 1.04, 95% CI, 1.02-1.07; P = .006, HR = 0.52, 95% CI, 0.33-0.83; respectively).
CONCLUSION: This study finds cystectomy eligibility to be associated with improved survival and underscores the importance of multi-disciplinary assessment in determining candidacy for organ preserving therapy in MIBC patients.
METHODS AND MATERIALS: Patients with high-risk non-MIBC or MIBC who underwent definitive bladder sparing treatment between 2006 and 2022 were included. Variables for analysis included age, sex, Charlson Comorbidity Index (CCI), surgical candidacy, neoadjuvant/induction chemotherapy (NAC), tumor size, presence of hydronephrosis, carcinoma in-situ, and histologic subtype. Kaplan-Meier analysis was done to calculate rates of overall survival (OS) and disease-free survival (DFS), while cumulative incidence analysis was done to calculate rates of cancer specific mortality (CSM) and local recurrence. Cox proportional hazards regression was done to identify factors associated with OS and DFS. Competing risk regression was done to identify factors associated with CSM and local recurrence.
RESULTS: 226 patients were included in the cohort with a median follow up of 18.9 months (range 0.9-172.3). The median age was 79 years (range 49-98) and 79.2% were male. On univariate Cox proportional hazards regression, younger age, NAC, and cystectomy candidacy were associated with improved OS (P < .0001, HR = 1.05, 95% CI, 1.03-1.08; P = .04, HR = 0.62, 95% CI, 0.39-0.99; P < .0001, HR = 0.42, 95% CI, 0.27-0.65; respectively). On multivariable analysis, only younger age and cystectomy eligibility were associated with improved OS (P = .002, HR = 1.04, 95% CI, 1.02-1.07; P = .006, HR = 0.52, 95% CI, 0.33-0.83; respectively).
CONCLUSION: This study finds cystectomy eligibility to be associated with improved survival and underscores the importance of multi-disciplinary assessment in determining candidacy for organ preserving therapy in MIBC patients.