Comparison of the prognosis of primary vs. progressive muscle invasive bladder cancer after radical cystectomy: Results from a large multicenter study
| Autor: | C. Lenormand, Alexandre Gryn, Gregory Verhoest, Mathieu Roumiguié, Evanguelos Xylinas, Thomas Prudhomme, Vivien Grafeille, François-Xavier Nouhaud, Abderrazak Bouzouita, Idir Ouzaid, Michel Soulié, Mohamed Chebil, Christian Pfister, Marouene Chakroun, Benoit Peyronnet |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Urology medicine.medical_treatment 030232 urology & nephrology Cystectomy 03 medical and health sciences 0302 clinical medicine medicine Humans Neoplasm Invasiveness Stage (cooking) Pathological Aged Retrospective Studies Bladder cancer business.industry Hazard ratio Muscle invasive Retrospective cohort study Middle Aged medicine.disease Prognosis Oncology Urinary Bladder Neoplasms 030220 oncology & carcinogenesis Disease Progression Female Positive Surgical Margin business |
| Zdroj: | Urologic oncology. 39(3) |
| ISSN: | 1873-2496 |
| Popis: | Purpose To assess whether progressive and primary muscle invasive bladder cancer (MIBC) have different prognosis after radical cystectomy or not. To date only a few data are available on this topic with conflicting results. Further studies on large cohort are needed to clarify these outcomes that may influence bladder cancer management for these patients. Material and methods A multicentre retrospective study was conducted on patient treated for MIBC at 5 centres between 2005 and 2015 by radical cystectomy. Patients’ outcomes were compared between patients with primary MIBC vs. progressive MIBC subsequent to a history of non-muscle invasive bladder cancer (NMIBC). Results A total of 1197 patients were included. Median (IQ) age was 65 (58–72) years and median follow-up was 65 months. Baseline characteristics were similar between the groups as well as the Tumour pT stage, N status and positive surgical margins. Patients with progressive MIBC had worse overall survival (OS) (hazard ratio [HR] 1.36, [95%CI 1.10–1.76]; P = 0.004), cancer specific survival (CSS) (HR 1.41 [1.13–1.78]; P = 0.002), and recurrence-free survival (RFS) (HR 1.21 [1.01–1.49]; P = 0.05). Pathological stage ≥pT3, positive surgical margins, and positive lymph nodes status (pN+) were also found as predictors of OS, CSS, and RFS. Conclusions Our results suggest that patient having a progressive BC have a worse prognosis in terms of OS, PFS, and CSS than patient with primary disease. These 2 groups may require different management and patients with high risk NMIBC should be assessed properly to avoid progression and be offered early cystectomy. |
| Databáze: | OpenAIRE |
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