J 2019

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 et. al.

Basic information

Original name

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

Authors

STANÍK, Michal (703 Slovakia, guarantor), Alexandr POPRACH (203 Czech Republic), Michaela ZAPLETALOVÁ (203 Czech Republic, belonging to the institution), Denisa KREJČÍ (203 Czech Republic, belonging to the institution), Daniel MACIK (203 Czech Republic), Ivo CAPAK (203 Czech Republic), Jiří JARKOVSKÝ (203 Czech Republic, belonging to the institution), Radek LAKOMY (203 Czech Republic) and Jan DOLEZEL (203 Czech Republic)

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30204 Oncology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 2.695

RIV identification code

RIV/00216224:14110/19:00111954

Organization unit

Faculty of Medicine

DOI

UT WoS

000476618100006

Keywords in English

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

Tags

Tags

International impact, Reviewed
Změněno: 3/1/2020 12:10, Mgr. Tereza Miškechová

Abstract

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.