The effect of radical cystectomy on survival in patients with metastatic urothelial carcinoma of the urinary bladder
Articolo
Data di Pubblicazione:
2019
Citazione:
The effect of radical cystectomy on survival in patients with metastatic urothelial carcinoma of the urinary bladder / S. Luzzago, C. Palumbo, G. Rosiello, A. Pecoraro, M. Deuker, Z. Tian, S.F. Shariat, F. Saad, O. de Cobelli, P.I. Karakiewicz. - In: JOURNAL OF SURGICAL ONCOLOGY. - ISSN 0022-4790. - 120:7(2019), pp. 1266-1275. [10.1002/jso.25717]
Abstract:
Background: To test the effect of radical cystectomy (RC) with chemotherapy vs only chemotherapy on overall mortality (OM) in metastatic urothelial carcinoma of the urinary bladder (mUCUB). Methods: Within the Surveillance, Epidemiology, and End Results registry (2004–2016), we identified patients with mUCUB. Stratification was made according to treatment: RC with chemotherapy vs only chemotherapy. Kaplan-Meier plots and multivariable Cox regression models were used before and after 1:1 propensity score (PS) matching and inverse probability of treatment weighting (IPTW). Results: Of 2414 patients with mUCUB, 500 (21.0%) vs 1914 (79.0%) were treated with RC with chemotherapy vs only chemotherapy, respectively. In multivariable Cox regression models, RC with chemotherapy was associated with lower OM in the overall cohort (hazard ratio [HR], 0.5; P <.001), after 1:1 PS matching (HR, 0.5; P <.001), after IPTW (HR, 0.5; P <.001) and after accounting for number and location of metastases (HR, 0.5; P <.001). However, higher overall survival after RC with chemotherapy was only observed in patients with one metastatic site (21 vs 16 months; P =.001). Conclusion: In contemporary patients with mUCUB, RC with chemotherapy is associated with lower OM rates, relative to chemotherapy alone, but only in patients with a single metastatic site. These individuals accounted for the vast majority of patients in whom an RC was performed, despite the presence of metastatic disease.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
chemotherapy; metastatic urothelial carcinoma of the urinary bladder; radical cystectomy; Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Transitional Cell; Combined Modality Therapy; Cystectomy; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prognosis; Retrospective Studies; SEER Program; Survival Rate; Urinary Bladder Neoplasms
Elenco autori:
S. Luzzago, C. Palumbo, G. Rosiello, A. Pecoraro, M. Deuker, Z. Tian, S.F. Shariat, F. Saad, O. de Cobelli, P.I. Karakiewicz
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