Extranodal Extension Predicts Poor Survival Outcomes among Patients with Bladder Cancer
| Autor: | Yeong-Shiau Pu, Bo Zhi Zhuang, Chung-Hsin Chen, Chun-Ju Chiang, Yi An Liao, Wen Chung Lee |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty medicine.medical_treatment overall survival Article Cystectomy cancer-specific survival Internal medicine medicine Lymph node RC254-282 Bladder cancer business.industry Hazard ratio extranodal extension Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease Confidence interval Cancer registry adjuvant chemotherapy Dissection medicine.anatomical_structure bladder cancer Lymph business |
| Zdroj: | Cancers, Vol 13, Iss 4108, p 4108 (2021) Cancers Volume 13 Issue 16 |
| ISSN: | 2072-6694 |
| Popis: | Simple Summary Several lymph node-related prognosticators have been reported in bladder cancer patients with lymph node involvement who undergo radical cystectomy. However, the role of extranodal extension (ENE) remains debatable for outcome prediction. The aim of our study is to investigate the association between ENE and prognosis in Taiwanese patients with pathological nodal bladder cancer who were treated with radical cystectomy using a nationwide database. Our study concluded that ENE significantly reduced OS and CSS among the pathological nodal bladder cancer patients. After the identification of pathological nodal disease, adjuvant chemotherapy was associated with better survival outcomes in the patients with ENE. Abstract Background: Several lymph node-related prognosticators were reported in bladder cancer patients with lymph node involvement and receiving radical cystectomy. However, extranodal extension (ENE) remained a debate to predict outcomes. Methods: A retrospective analysis of 1303 bladder cancer patients receiving radical cystectomy and bilateral pelvic lymph node dissection were identified in the National Taiwan Cancer Registry database from 2011 to 2017. Based on the 304 patients with lymph node involvement, the presence of ENE and major clinical information were recorded and calculated. The overall survival (OS) and cancer-specific survival (CSS) were estimated with Kaplan–Meier analysis and compared using the log-rank test. Hazard ratios (HR) and the associated 95% confidence intervals were calculated in the univariate and stepwise multivariable models. Results: In the multivariable analysis, ENE significantly reduced OS (HR = 1.74, 95% CI 1.09–2.78) and CSS (HR = 1.69, 95% CI 1.01–2.83) more than non-ENE. In contrast, adjuvant chemotherapy was significantly associated with better OS and CSS upon the identification of pathological nodal disease. Conclusions: Reduced OS and CSS outcomes were observed in the pathological nodal bladder cancer patients with ENE compared with those without ENE. After the identification of pathological nodal disease, adjuvant chemotherapy was associated with better survival outcomes. |
| Databáze: | OpenAIRE |
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