Comparison of Outcomes in Patients With Muscle-invasive Bladder Cancer Treated With Radical Cystectomy Versus Bladder Preservation
| Autor: | Viraj A. Master, Peter T. Nieh, Jim Zhong, Christopher P. Filson, Theresa W. Gillespie, Bradley C. Carthon, N. Jegadeesh, Mehrdad Alemozaffar, Mehmet Asim Bilen, Jeffrey M. Switchenko, Ashesh B. Jani, Omer Kucuk, Richard J. Cassidy |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Standard of care medicine.medical_treatment Urinary Bladder Urology Comorbidity Kaplan-Meier Estimate Cystectomy urologic and male genital diseases Article Bladder preservation 03 medical and health sciences 0302 clinical medicine medicine Humans In patient 030212 general & internal medicine Organ Sparing Treatments Aged Bladder cancer business.industry Muscle invasive Chemoradiotherapy medicine.disease female genital diseases and pregnancy complications Treatment Outcome Urinary Bladder Neoplasms Oncology 030220 oncology & carcinogenesis Female business |
| Zdroj: | American Journal of Clinical Oncology. 42:36-41 |
| ISSN: | 0277-3732 |
| DOI: | 10.1097/coc.0000000000000471 |
| Popis: | PURPOSE: Radical cystectomy currently remains the standard of care for muscle-invasive bladder cancer (MIBC). However, surgery can be associated with considerable morbidity and mortality, including the removal of the bladder. An alternative strategy is to preserve the bladder through concurrent chemo-radiation following a maximal trans-urethral resection of the tumor. National protocols using a bladder preservation approach have demonstrated disease-specific outcomes comparable to radical cystectomy in selected patients, but these results have not been replicated in previously reported population-based series. Here, we describe an outcomes analysis of patients with MIBC treated with either radical surgery or bladder-preserving chemo-radiation (BPCRT) for those patients meeting BPCRT criterion using the National Cancer Database (NCDB). METHODS AND MATERIALS: Using the NCDB, patients with AJCC clinical T2-3, N0, M0 urothelial carcinoma diagnosed between 2004–2013 were included for analysis. Only patients treated with definitive intent with either radical cystectomy or concurrent chemotherapy and radiation after a maximal transurethral tumor resection were included. Propensity-score matching was employed. RESULTS: Among 8,454 eligible patients, 7,276 (86%) underwent radical cystectomy, and 1,178 (14%) underwent BPCRT. Patients undergoing BPCRT were significantly older (median age 77 vs 68, p |
| Databáze: | OpenAIRE |
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