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SHR Neuro Cancer Cardio Lipid Metab Microb

de, Angelis, M; Scheipner, L; Siech, C; Jannello, LMI; Baudo, A; Bello, FD; Goyal, JA; Vitucci, K; Tian, Z; Longo, N; Ahyai, S; de, Cobelli, O; Chun, FKH; Saad, F; Shariat, SF; Carmignani, L; Gandaglia, G; Moschini, M; Montorsi, F; Briganti, A; Karakiewicz, PI.
Temporal Trends and Cancer-Specific Mortality in Nonmetastatic Muscle-Invasive Urothelial Carcinoma of the Urinary Bladder Treated With Trimodal Therapy.
Clin Genitourin Cancer. 2024; 22(4):102119 Doi: 10.1016/j.clgc.2024.102119
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Co-authors Med Uni Graz: Ahyai Sascha; Scheipner Lukas
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Abstract:: INTRODUCTION: Trimodal therapy (TMT) is guideline-recommended for the management of organ confined urothelial carcinoma of urinary bladder (UCUB). However, temporal trends in TMT use and cancer-specific mortality free-survival (CSM-FS) between historical TMT versus contemporary TMT have not been assessed. We addressed this knowledge gap. MATERIAL AND METHODS: Within the Surveillance, Epidemiology, and End Results database (2004-2020), we identified nonmetastatic UCUB patients with cT2-T4aN0-N2 treated with TMT, defined as the combination of transurethral resection of bladder tumor, chemotherapy and radiotherapy. Temporal trends described TMT use over time. Subsequently, patients were divided between historical (2004-2012) versus contemporary (2013-2020) cohorts. Survival analyses consisting of Kaplan-Meier plots and multivariable Cox regression (MCR) models addressed CSM-FS. Separate analyses addressed patients with organ confined (OC: cT2N0M0) versus nonorgan confined (NOC: cT3-4a and/or cN1-2) clinical stages. RESULTS: Of 4,097 assessable UCUB TMT patients, 1744 (43%) were treated in the historical period (2004-2012) versus 2353 (58%) in the contemporary period (2013-2020). TMT use increased over time in OC patients (EAPC:+3.4%, P < .001), as well as in NOC (EAPC:+2.7%, P < .001). In OC stage, median CSM-FS was 55.3% in historical versus 49.0% in contemporary patients (HR:0.75, P < .001). Similarly, in NOC stage, 5-year median CSM-FS was 43.0% in historical versus 32.8% in contemporary patients (HR:0.78, P = .01). CONCLUSION: TMT rates have increased over time in both OC and NOC patients. Contemporary TMT patients benefit of better cancer-specific survival. Interestingly, this benefit applies equally to OC and NOC TMT-treated patients.
Find related publications in this database (using NLM MeSH Indexing): Humans - administration & dosage; Urinary Bladder Neoplasms - mortality, therapy, pathology; Male - administration & dosage; Female - administration & dosage; Aged - administration & dosage; Middle Aged - administration & dosage; SEER Program - administration & dosage; Carcinoma, Transitional Cell - mortality, therapy, pathology; Neoplasm Staging - administration & dosage; Combined Modality Therapy - administration & dosage; Cystectomy - administration & dosage; Aged, 80 and over - administration & dosage; Retrospective Studies - administration & dosage; Neoplasm Invasiveness - administration & dosage; Kaplan-Meier Estimate - administration & dosage
Find related publications in this database (Keywords): Bladder cancer; Organ confined; Muscle-invasive bladder cancer; Multimodal treatment; Survival