EORTC progression score identifies patients at high risk of cancer-specific mortality after radical cystectomy for secondary muscle-invasive bladder cancer
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EORTC progression score identifies patients at high risk of cancer-specific mortality after radical cystectomy for secondary muscle-invasive bladder cancer. / May, Matthias; Burger, Maximilian; Brookman-May, Sabine; Stief, Christian G; Fritsche, Hans-Martin; Roigas, Jan; Zacharias, Mario; Bader, Markus; Mandel, Philipp; Gilfrich, Christian; Seitz, Michael; Tilki, Derya.
in: CLIN GENITOURIN CANC, Jahrgang 12, Nr. 4, 08.2014, S. 278-86.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - EORTC progression score identifies patients at high risk of cancer-specific mortality after radical cystectomy for secondary muscle-invasive bladder cancer
AU - May, Matthias
AU - Burger, Maximilian
AU - Brookman-May, Sabine
AU - Stief, Christian G
AU - Fritsche, Hans-Martin
AU - Roigas, Jan
AU - Zacharias, Mario
AU - Bader, Markus
AU - Mandel, Philipp
AU - Gilfrich, Christian
AU - Seitz, Michael
AU - Tilki, Derya
N1 - Copyright © 2014 Elsevier Inc. All rights reserved.
PY - 2014/8
Y1 - 2014/8
N2 - BACKGROUND: The aim of this study was to develop a risk stratification of patients with muscle-invasive bladder cancer (MIBC) after radical cystectomy (RC). For this purpose, we compared the cancer-specific mortality (CSM) of patients with primary MIBC and patients with secondary MIBC in different risk groups according to the European Organisation for Research and Treatment of Cancer (EORTC) progression score.PATIENTS AND METHODS: The records of 521 consecutive patients treated with RC for clinical MIBC according to transurethral resection of bladder cancer (TURBT) diagnosis were reviewed. Of the 521 patients, 399 (76.6%) had primary MIBC (study group 1 [SG1]) and 122 (23.4%) had secondary MIBC (study group 2 [SG2]). Patients in SG2 were stratified into risk groups according to the results of the first and last TURBT in non-MIBC using the EORTC progression score.RESULTS: CSM for patients with primary and secondary MIBC did not differ significantly. Patients in SG2 with the highest risk for tumor stage progression at time of the first and last TURBT in non-MIBC showed a significantly higher CSM after RC compared with patients with low-to-intermediate risk and compared with patients in SG1. In multivariable analyses, stage pT 3/4 (hazard ratio [HR], 2.12; P < .001), lymphovascular invasion (LVI) (HR, 3.47; P < .001), female sex (HR, 1.35; P = .048), and time from diagnosis of MIBC to RC > 90 days (HR, 2.07; P < .001) were significantly associated with higher CSM.CONCLUSION: Risk stratification by the EORTC progression score can help to identify those patients with the highest risk of CSM after progression to MIBC and thus enable us to offer these patients a multimodal treatment. Our results need to be verified in large prospective studies.
AB - BACKGROUND: The aim of this study was to develop a risk stratification of patients with muscle-invasive bladder cancer (MIBC) after radical cystectomy (RC). For this purpose, we compared the cancer-specific mortality (CSM) of patients with primary MIBC and patients with secondary MIBC in different risk groups according to the European Organisation for Research and Treatment of Cancer (EORTC) progression score.PATIENTS AND METHODS: The records of 521 consecutive patients treated with RC for clinical MIBC according to transurethral resection of bladder cancer (TURBT) diagnosis were reviewed. Of the 521 patients, 399 (76.6%) had primary MIBC (study group 1 [SG1]) and 122 (23.4%) had secondary MIBC (study group 2 [SG2]). Patients in SG2 were stratified into risk groups according to the results of the first and last TURBT in non-MIBC using the EORTC progression score.RESULTS: CSM for patients with primary and secondary MIBC did not differ significantly. Patients in SG2 with the highest risk for tumor stage progression at time of the first and last TURBT in non-MIBC showed a significantly higher CSM after RC compared with patients with low-to-intermediate risk and compared with patients in SG1. In multivariable analyses, stage pT 3/4 (hazard ratio [HR], 2.12; P < .001), lymphovascular invasion (LVI) (HR, 3.47; P < .001), female sex (HR, 1.35; P = .048), and time from diagnosis of MIBC to RC > 90 days (HR, 2.07; P < .001) were significantly associated with higher CSM.CONCLUSION: Risk stratification by the EORTC progression score can help to identify those patients with the highest risk of CSM after progression to MIBC and thus enable us to offer these patients a multimodal treatment. Our results need to be verified in large prospective studies.
KW - Aged
KW - Cystectomy
KW - Disease Progression
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Muscle Neoplasms
KW - Neoplasm Grading
KW - Neoplasm Invasiveness
KW - Neoplasm Staging
KW - Prognosis
KW - Risk Assessment
KW - Survival Rate
KW - Urinary Bladder Neoplasms
KW - Journal Article
U2 - 10.1016/j.clgc.2013.11.014
DO - 10.1016/j.clgc.2013.11.014
M3 - SCORING: Journal article
C2 - 24331576
VL - 12
SP - 278
EP - 286
JO - CLIN GENITOURIN CANC
JF - CLIN GENITOURIN CANC
SN - 1558-7673
IS - 4
ER -
