Impact of age on outcomes of patients with non-muscle-invasive bladder cancer treated with immediate postoperative instillation of mitomycin C
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Impact of age on outcomes of patients with non-muscle-invasive bladder cancer treated with immediate postoperative instillation of mitomycin C. / Xylinas, Evanguelos; Kent, Matthew; Dabi, Yohann; Rieken, Malte; Kluth, Luis A; Al Awamlh, Bashir Al Hussein; Ouzaid, Idir; Pycha, Armin; Comploj, Evi; Svatek, Robert S; Lotan, Yair; Karakiewicz, Pierre I; Holmang, Sten; Shariat, Shahrokh F.
in: UROL ONCOL-SEMIN ORI, Jahrgang 36, Nr. 3, 03.2018, S. 89.e1-89.e5.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Impact of age on outcomes of patients with non-muscle-invasive bladder cancer treated with immediate postoperative instillation of mitomycin C
AU - Xylinas, Evanguelos
AU - Kent, Matthew
AU - Dabi, Yohann
AU - Rieken, Malte
AU - Kluth, Luis A
AU - Al Awamlh, Bashir Al Hussein
AU - Ouzaid, Idir
AU - Pycha, Armin
AU - Comploj, Evi
AU - Svatek, Robert S
AU - Lotan, Yair
AU - Karakiewicz, Pierre I
AU - Holmang, Sten
AU - Shariat, Shahrokh F
N1 - Copyright © 2017 Elsevier Inc. All rights reserved.
PY - 2018/3
Y1 - 2018/3
N2 - OBJECTIVES: To evaluate whether age affects the clinical benefit afforded by immediate postoperative intravesical instillation of mitomycin C in a contemporary cohort of patients with NMIBC.PATIENTS AND METHODS: A total of 4,258 patients with NMIBC treated with transurethral resection of the bladder with (n = 2,605, 61%) or without (n = 1,652, 39%) one immediate instillation of mitomycin C from 5 institutions (study period: 2000-2007) were included. No patients received adjuvant instillations. A multivariable Cox proportional hazards regression model adjusting for standard clinical and pathological features tested the potential interaction term between age and administration of mitomycin C with regard to disease recurrence.RESULTS: A total of 2,063 patients experienced disease recurrence with a median follow-up of 48 months for those who did not recur. In multivariable Cox regression analysis, immediate postoperative instillation of mitomycin C (HR: 0.62; 95% CI: 0.56-0.68; P<0.0001) and age (HR: 1.04; 95% CI: 1.00-1.09; P = 0.036) were associated with disease recurrence. We observed only slight decreases in recurrence-free survival with age irrespective of treatment administration of mitomycin C or not.CONCLUSION: We confirmed reduced disease recurrence rates associated with 1 immediate postoperative intravesical instillation of mitomycin C in NMIBC patients. The benefit on recurrence-free survival of a postoperative intravesical instillation was preserved across all ages and therefore age by itself should not be taken into consideration when deciding to use it.
AB - OBJECTIVES: To evaluate whether age affects the clinical benefit afforded by immediate postoperative intravesical instillation of mitomycin C in a contemporary cohort of patients with NMIBC.PATIENTS AND METHODS: A total of 4,258 patients with NMIBC treated with transurethral resection of the bladder with (n = 2,605, 61%) or without (n = 1,652, 39%) one immediate instillation of mitomycin C from 5 institutions (study period: 2000-2007) were included. No patients received adjuvant instillations. A multivariable Cox proportional hazards regression model adjusting for standard clinical and pathological features tested the potential interaction term between age and administration of mitomycin C with regard to disease recurrence.RESULTS: A total of 2,063 patients experienced disease recurrence with a median follow-up of 48 months for those who did not recur. In multivariable Cox regression analysis, immediate postoperative instillation of mitomycin C (HR: 0.62; 95% CI: 0.56-0.68; P<0.0001) and age (HR: 1.04; 95% CI: 1.00-1.09; P = 0.036) were associated with disease recurrence. We observed only slight decreases in recurrence-free survival with age irrespective of treatment administration of mitomycin C or not.CONCLUSION: We confirmed reduced disease recurrence rates associated with 1 immediate postoperative intravesical instillation of mitomycin C in NMIBC patients. The benefit on recurrence-free survival of a postoperative intravesical instillation was preserved across all ages and therefore age by itself should not be taken into consideration when deciding to use it.
KW - Journal Article
U2 - 10.1016/j.urolonc.2017.11.010
DO - 10.1016/j.urolonc.2017.11.010
M3 - SCORING: Journal article
C2 - 29221642
VL - 36
SP - 89.e1-89.e5
JO - UROL ONCOL-SEMIN ORI
JF - UROL ONCOL-SEMIN ORI
SN - 1078-1439
IS - 3
ER -