Adenocarcinoma of the Bladder: Assessment of Survival Advantage Associated With Radical Cystectomy and Comparison With Urothelial Bladder Cancer
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Adenocarcinoma of the Bladder: Assessment of Survival Advantage Associated With Radical Cystectomy and Comparison With Urothelial Bladder Cancer. / Tappero, Stefano; Barletta, Francesco; Piccinelli, Mattia Luca; Cano Garcia, Cristina; Incesu, Reha-Baris; Morra, Simone; Scheipner, Lukas; Tian, Zhe; Parodi, Stefano; Dell'Oglio, Paolo; Briganti, Alberto; de Cobelli, Ottavio; Chun, Felix K H; Graefen, Markus; Mirone, Vincenzo; Ahyai, Sascha; Saad, Fred; Shariat, Shahrokh F; Suardi, Nazareno; Borghesi, Marco; Terrone, Carlo; Karakiewicz, Pierre I.
In: UROL ONCOL-SEMIN ORI, Vol. 41, No. 7, 07.2023, p. 326.e9-326.e16.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Adenocarcinoma of the Bladder: Assessment of Survival Advantage Associated With Radical Cystectomy and Comparison With Urothelial Bladder Cancer
AU - Tappero, Stefano
AU - Barletta, Francesco
AU - Piccinelli, Mattia Luca
AU - Cano Garcia, Cristina
AU - Incesu, Reha-Baris
AU - Morra, Simone
AU - Scheipner, Lukas
AU - Tian, Zhe
AU - Parodi, Stefano
AU - Dell'Oglio, Paolo
AU - Briganti, Alberto
AU - de Cobelli, Ottavio
AU - Chun, Felix K H
AU - Graefen, Markus
AU - Mirone, Vincenzo
AU - Ahyai, Sascha
AU - Saad, Fred
AU - Shariat, Shahrokh F
AU - Suardi, Nazareno
AU - Borghesi, Marco
AU - Terrone, Carlo
AU - Karakiewicz, Pierre I
N1 - Copyright © 2023 Elsevier Inc. All rights reserved.
PY - 2023/7
Y1 - 2023/7
N2 - PURPOSE: To evaluate the association between radical cystectomy (RC) and cancer-specific mortality (CSM) in patients diagnosed with adenocarcinoma of the bladder (ACB). Moreover, to directly compare the survival advantage of RC between ACB vs. urothelial bladder cancer (UBC).MATERIALS AND METHODS: Non-metastatic muscle-invasive ACB and UBC patients were identified within Surveillance, Epidemiology, and End Results database (SEER 2000-2018). All analyses were stratified between RC vs. no-RC, in either organ-confined (OC: T2N0M0) or non-organ-confined (NOC: T3-4N0M0 or TanyN1-3M0) stages. Propensity score matching (PSM), cumulative incidence plots, competing risks regression (CRR) analyses, and 3 months' landmark analyses were performed.RESULTS: Overall, 1,005 ACB and 47,741 UBC patients were identified, of whom 475 (47%) and 19,499 (41%) were treated with RC, respectively. After PSM, comparison between RC vs. no-RC applied to 127 vs. 127 OC-ACB, 7,611 vs. 7,611 OC-UBC, 143 vs. 143 NOC-ACB, and 4,664 vs. 4,664 NOC-UBC patients. 36-month CSM rates in RC vs. no-RC patients were 14 vs. 44% in OC-ACB, 18 vs. 39% in OC-UBC, 49 vs. 66% in NOC-ACB, and 44 vs. 56% in NOC-UBC patients. In CRR analyses, the effect of RC on CSM yielded a hazard ratio of 0.37 in OC-ACB, of 0.45 in OC-UBC, of 0.65 in NOC-ACB and of 0.68 in NOC-UBC patients (all P values<0.001). Landmark analyses virtually perfectly replicated the results.CONCLUSIONS: In ACB, regardless of stage, RC is associated with lower CSM. The magnitude of this survival advantage was greater in ACB than in UBC, even after control for immortal time bias.
AB - PURPOSE: To evaluate the association between radical cystectomy (RC) and cancer-specific mortality (CSM) in patients diagnosed with adenocarcinoma of the bladder (ACB). Moreover, to directly compare the survival advantage of RC between ACB vs. urothelial bladder cancer (UBC).MATERIALS AND METHODS: Non-metastatic muscle-invasive ACB and UBC patients were identified within Surveillance, Epidemiology, and End Results database (SEER 2000-2018). All analyses were stratified between RC vs. no-RC, in either organ-confined (OC: T2N0M0) or non-organ-confined (NOC: T3-4N0M0 or TanyN1-3M0) stages. Propensity score matching (PSM), cumulative incidence plots, competing risks regression (CRR) analyses, and 3 months' landmark analyses were performed.RESULTS: Overall, 1,005 ACB and 47,741 UBC patients were identified, of whom 475 (47%) and 19,499 (41%) were treated with RC, respectively. After PSM, comparison between RC vs. no-RC applied to 127 vs. 127 OC-ACB, 7,611 vs. 7,611 OC-UBC, 143 vs. 143 NOC-ACB, and 4,664 vs. 4,664 NOC-UBC patients. 36-month CSM rates in RC vs. no-RC patients were 14 vs. 44% in OC-ACB, 18 vs. 39% in OC-UBC, 49 vs. 66% in NOC-ACB, and 44 vs. 56% in NOC-UBC patients. In CRR analyses, the effect of RC on CSM yielded a hazard ratio of 0.37 in OC-ACB, of 0.45 in OC-UBC, of 0.65 in NOC-ACB and of 0.68 in NOC-UBC patients (all P values<0.001). Landmark analyses virtually perfectly replicated the results.CONCLUSIONS: In ACB, regardless of stage, RC is associated with lower CSM. The magnitude of this survival advantage was greater in ACB than in UBC, even after control for immortal time bias.
KW - Humans
KW - Urinary Bladder/surgery
KW - Cystectomy/methods
KW - SEER Program
KW - Urinary Bladder Neoplasms/pathology
KW - Carcinoma, Transitional Cell/pathology
KW - Adenocarcinoma
KW - Retrospective Studies
U2 - 10.1016/j.urolonc.2023.01.015
DO - 10.1016/j.urolonc.2023.01.015
M3 - SCORING: Journal article
C2 - 36882338
VL - 41
SP - 326.e9-326.e16
JO - UROL ONCOL-SEMIN ORI
JF - UROL ONCOL-SEMIN ORI
SN - 1078-1439
IS - 7
ER -