Comparison of Different Treatment Modalities Outcomes in Clinically Node-positive Bladder Cancer: Analysis of a Population-based Cancer Registry

STANÍK, Michal; Alexandr POPRACH; Michaela ZAPLETALOVÁ; Denisa KREJČÍ; Daniel MACIK; Ivo CAPAK; Jiří JARKOVSKÝ; Radek LAKOMY a Jan DOLEZEL. Comparison of Different Treatment Modalities Outcomes in Clinically Node-positive Bladder Cancer: Analysis of a Population-based Cancer Registry. CLINICAL GENITOURINARY CANCER. DALLAS: CIG MEDIA GROUP, LP, 2019, roč. 17, č. 4, s. "E759"-"E767", 9 s. ISSN 1558-7673. Dostupné z: https://doi.org/10.1016/j.clgc.2019.04.007.

Základní údaje

Originální název

Comparison of Different Treatment Modalities Outcomes in Clinically Node-positive Bladder Cancer: Analysis of a Population-based Cancer Registry

Autoři

STANÍK, Michal; Alexandr POPRACH; Michaela ZAPLETALOVÁ; Denisa KREJČÍ; Daniel MACIK; Ivo CAPAK; Jiří JARKOVSKÝ ORCID; Radek LAKOMY a Jan DOLEZEL

Vydání

CLINICAL GENITOURINARY CANCER, DALLAS, CIG MEDIA GROUP, LP, 2019, 1558-7673

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Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30204 Oncology

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.695

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/19:00111954

Organizační jednotka

Lékařská fakulta

DOI

https://doi.org/10.1016/j.clgc.2019.04.007

UT WoS

000476618100006

EID Scopus

2-s2.0-85065534259

Klíčová slova anglicky

Chemotherapy; Combined modality therapy; Cystectomy; Lymphadenopathy; Urinary bladder neoplasms

Štítky

14119612, rivok

Příznaky

Mezinárodní význam, Recenzováno

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Anotace

V originále

Recently, a few retrospective studies demonstrated a potential benefit of multimodal therapy in patients with clinically node-positive bladder cancer. We assessed the efficacy of different treatment modalities in 661 patients (cTanyN1-3M0) identified from the Czech National Cancer Registry. When compared with chemotherapy, combined treatment integrating cystectomy and perioperative chemotherapy reduced the risk of overall mortality by 21% and may lead to a long-term survival in one-quarter of patients. Introduction: Patients with clinically node-positive bladder cancer were historically considered to have uniformly poor prognosis and were frequently treated with palliative chemotherapy (CHT) only. Although retrospective data show that long-term survival with combined treatment (surgery + CHT) is possible in one-third of these patients, consensus on a treatment algorithm is still lacking. The aim of the study is to compare the efficacy of different treatment modalities based on data from a population-based cancer registry. Patients and Methods: The study comprises 661 patients identified from the Czech National Cancer Registry (1996-2015) with cTanyN1-3M0 bladder cancer; 195 were treated with CHT alone, 234 underwent radical cystectomy alone (RC), and 232 received a combination of RC and perioperative CHT (RC + CHT). Multivariate Cox proportional hazard regression analyses were used to evaluate the effectiveness of various treatments. Results: The 5-year OS for CHT alone, RC alone, and RC + CHT were 21.7% (95% confidence interval [CI], 15.4%-28.0%), 12.1% (95% CI, 7.4%-16.7%), and 25.4% (95% CI, 18.9%-31.9%), respectively (P < .001). The median survivals were 17, 10, and 23 months, respectively. In multivariate analysis, age > 60 years (hazard ratio, 1.29; 95% CI, 1.06-1.56; P = .011) and clinical stage cT3-4 (hazard ratio, 1.39; 95% CI, 1.12-1.71; P = .002) were negative predictors of survival. When compared with CHT, RC + CHT reduced the risk of overall mortality by 21% (P = .044). Conclusion: Approximately one-quarter of clinically node-positive patients may achieve long-term survival with combined treatment integrating RC and perioperative CHT. The overall survival of patients is significantly improved with a multimodal approach in comparison to CHT alone. (C) 2019 Elsevier Inc. All rights reserved.