Impact of Baseline Characteristics on the Survival Benefit of High-Intensity Local Treatment in Metastatic Urothelial Carcinoma of the Bladder
Standard
Impact of Baseline Characteristics on the Survival Benefit of High-Intensity Local Treatment in Metastatic Urothelial Carcinoma of the Bladder. / Vetterlein, Malte W.; Karabon, Patrick; Dalela, Deepansh; Jindal, Tarun; Sood, Akshay; Seisen, Thomas; Trinh, Quoc-Dien; Menon, Mani; Abdollah, Firas.
in: EUR UROL FOCUS, Jahrgang 4, Nr. 4, 07.2018, S. 568-571.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › Andere (Vorworte u.ä.) › Forschung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Impact of Baseline Characteristics on the Survival Benefit of High-Intensity Local Treatment in Metastatic Urothelial Carcinoma of the Bladder
AU - Vetterlein, Malte W.
AU - Karabon, Patrick
AU - Dalela, Deepansh
AU - Jindal, Tarun
AU - Sood, Akshay
AU - Seisen, Thomas
AU - Trinh, Quoc-Dien
AU - Menon, Mani
AU - Abdollah, Firas
N1 - Brief Correspondence
PY - 2018/7
Y1 - 2018/7
N2 - A recent study reported an overall survival benefit for patients with metastatic urothelial carcinoma of the bladder (mUCB) managed with high-intensity local treatment (LT) of the primary tumor (chemotherapy plus radical cystectomy and/or radiation therapy ≥50Gy). Given the non-negligible morbidity of these procedures, adequate patient selection is crucial. Our objective was to identify patients who might benefit the most from high-intensity LT. Data for 3044 patients with mUCB at diagnosis were extracted from the National Cancer Data Base 2004-2013, and patients were categorized on the basis of treatment: high-intensity LT versus conservative LT (chemotherapy plus transurethral resection of bladder tumor and/or radiation therapy <50Gy). Multivariate Cox regression analysis predicted baseline 2-yr overall mortality (OM) risk among patients who received conservative LT. We then assessed the interaction between predicted OM risk and LT type. Compared to conservative LT, high-intensity LT yielded a higher observed OM-free survival rate among all patients with pure mUCB, irrespective of their predicted OM risk (nonsignificant interaction, p=0.7). These findings underline the need for further retrospective and prospective evaluation. PATIENT SUMMARY: Among patients with metastatic histologically pure urothelial carcinoma of the bladder, we found an overall survival benefit of high-intensity local treatment directed at the primary tumor, regardless of predicted baseline 2-yr overall mortality risk.
AB - A recent study reported an overall survival benefit for patients with metastatic urothelial carcinoma of the bladder (mUCB) managed with high-intensity local treatment (LT) of the primary tumor (chemotherapy plus radical cystectomy and/or radiation therapy ≥50Gy). Given the non-negligible morbidity of these procedures, adequate patient selection is crucial. Our objective was to identify patients who might benefit the most from high-intensity LT. Data for 3044 patients with mUCB at diagnosis were extracted from the National Cancer Data Base 2004-2013, and patients were categorized on the basis of treatment: high-intensity LT versus conservative LT (chemotherapy plus transurethral resection of bladder tumor and/or radiation therapy <50Gy). Multivariate Cox regression analysis predicted baseline 2-yr overall mortality (OM) risk among patients who received conservative LT. We then assessed the interaction between predicted OM risk and LT type. Compared to conservative LT, high-intensity LT yielded a higher observed OM-free survival rate among all patients with pure mUCB, irrespective of their predicted OM risk (nonsignificant interaction, p=0.7). These findings underline the need for further retrospective and prospective evaluation. PATIENT SUMMARY: Among patients with metastatic histologically pure urothelial carcinoma of the bladder, we found an overall survival benefit of high-intensity local treatment directed at the primary tumor, regardless of predicted baseline 2-yr overall mortality risk.
KW - Cystectomy
KW - Surgical cytoreduction procedures
KW - Neoplasm metastasis
KW - Radiotherapy
KW - Urinary bladder neoplasms
KW - Aged
KW - Carcinoma, Transitional Cell/mortality
KW - Chemoradiotherapy, Adjuvant/adverse effects
KW - Cystectomy/adverse effects
KW - Female
KW - Humans
KW - Kaplan-Meier Estimate
KW - Male
KW - Middle Aged
KW - Neoplasm Metastasis
KW - Neoplasm Staging
KW - Outcome Assessment, Health Care
KW - Patient Selection
KW - Risk Assessment/methods
KW - Survival Rate
KW - Urinary Bladder/pathology
KW - Urinary Bladder Neoplasms/mortality
U2 - 10.1016/j.euf.2016.12.003
DO - 10.1016/j.euf.2016.12.003
M3 - Other (editorial matter etc.)
C2 - 28753834
VL - 4
SP - 568
EP - 571
JO - EUR UROL FOCUS
JF - EUR UROL FOCUS
SN - 2405-4569
IS - 4
ER -
