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Comparative Outcomes of Primary Versus Recurrent High-risk Non-muscle-invasive and Primary Versus Secondary Muscle-invasive Bladder Cancer After Radical Cystectomy: Results from a Retrospective Multicenter Study

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Comparative Outcomes of Primary Versus Recurrent High-risk Non-muscle-invasive and Primary Versus Secondary Muscle-invasive Bladder Cancer After Radical Cystectomy: Results from a Retrospective Multicenter Study. / Grossmann, Nico C; Rajwa, Pawel; Quhal, Fahad; König, Frederik; Mostafaei, Hadi; Laukhtina, Ekaterina; Mori, Keiichiro; Katayama, Satoshi; Motlagh, Reza Sari; Fankhauser, Christian D; Mattei, Agostino; Moschini, Marco; Chlosta, Piotr; van Rhijn, Bas W G; Teoh, Jeremy Y C; Compérat, Eva; Babjuk, Marek; Abufaraj, Mohammad; Karakiewicz, Pierre I; Shariat, Shahrokh F; Pradere, Benjamin.

In: EUR UROL OPEN SCI, Vol. 39, 05.2022, p. 14-21.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Grossmann, NC, Rajwa, P, Quhal, F, König, F, Mostafaei, H, Laukhtina, E, Mori, K, Katayama, S, Motlagh, RS, Fankhauser, CD, Mattei, A, Moschini, M, Chlosta, P, van Rhijn, BWG, Teoh, JYC, Compérat, E, Babjuk, M, Abufaraj, M, Karakiewicz, PI, Shariat, SF & Pradere, B 2022, 'Comparative Outcomes of Primary Versus Recurrent High-risk Non-muscle-invasive and Primary Versus Secondary Muscle-invasive Bladder Cancer After Radical Cystectomy: Results from a Retrospective Multicenter Study', EUR UROL OPEN SCI, vol. 39, pp. 14-21. https://doi.org/10.1016/j.euros.2022.02.011

APA

Grossmann, N. C., Rajwa, P., Quhal, F., König, F., Mostafaei, H., Laukhtina, E., Mori, K., Katayama, S., Motlagh, R. S., Fankhauser, C. D., Mattei, A., Moschini, M., Chlosta, P., van Rhijn, B. W. G., Teoh, J. Y. C., Compérat, E., Babjuk, M., Abufaraj, M., Karakiewicz, P. I., ... Pradere, B. (2022). Comparative Outcomes of Primary Versus Recurrent High-risk Non-muscle-invasive and Primary Versus Secondary Muscle-invasive Bladder Cancer After Radical Cystectomy: Results from a Retrospective Multicenter Study. EUR UROL OPEN SCI, 39, 14-21. https://doi.org/10.1016/j.euros.2022.02.011

Vancouver

Grossmann NC, Rajwa P, Quhal F, König F, Mostafaei H, Laukhtina E et al. Comparative Outcomes of Primary Versus Recurrent High-risk Non-muscle-invasive and Primary Versus Secondary Muscle-invasive Bladder Cancer After Radical Cystectomy: Results from a Retrospective Multicenter Study. EUR UROL OPEN SCI. 2022 May;39:14-21. https://doi.org/10.1016/j.euros.2022.02.011

Bibtex

@article{3947ccdd375047739d191237f6fded9c,
title = "Comparative Outcomes of Primary Versus Recurrent High-risk Non-muscle-invasive and Primary Versus Secondary Muscle-invasive Bladder Cancer After Radical Cystectomy: Results from a Retrospective Multicenter Study",
abstract = "BACKGROUND: Radical cystectomy (RC) is indicated in primary or secondary muscle-invasive bladder cancer (primMIBC, secMIBC) and in primary or recurrent high- or very high-risk non-muscle-invasive bladder cancer (primHR-NMIBC, recHR-NMIBC). The optimal timing for RC along the disease spectrum of nonmetastatic urothelial carcinoma remains unclear.OBJECTIVE: To compare outcomes after RC between patients with primHR-NMIBC, recHR-NMIBC, primMIBC, and secMIBC.DESIGN SETTING AND PARTICIPANTS: This retrospective, multicenter study included patients with clinically nonmetastatic bladder cancer (BC) treated with RC.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We assessed oncological outcomes for patients who underwent RC according to the natural history of their BC. primHR-NMIBC and primMIBC were defined as no prior history of BC, and recHR-NMIBC and secMIBC as previously treated NMIBC that recurred or progressed to MIBC, respectively. Log-rank analysis was used to compare survival outcomes, and univariable and multivariable Cox and logistic regression analyses were used to identify predictors for survival.RESULTS AND LIMITATIONS: Among the 908 patients included, 211 (23%) had primHR-NMIBC, 125 (14%) had recHR-NMIBC, 404 (44%) had primMIBC, and 168 (19%) had secMIBC. Lymph node involvement and pathological upstaging were more frequent in the secMIBC group than in the other groups (p < 0.001). The median follow-up was 37 mo. The 5-year recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) were 77.9%, 83.2%, and 72.7% in primHR-NMIBC, 60.0%, 59%, and 48.9% in recHR-NMIBC, 60.9%, 64.5%, and 54.8% in primMIBC, and 41.3%, 46.5%, and 39% in secMIBC, respectively, with statistically significant differences across all survival outcomes except between recHR-NMIBC and primMIBC. On multivariable Cox regression, recHR-NMIBC was independently associated with shorter RFS (hazard ratio [HR] 1.64; p = 0.03), CSS (HR 1.79; p = 0.01), and OS (HR 1.45; p = 0.03), and secMIBC was associated with shorter CSS (HR 1.77; p = 0.01) and OS (HR 1.57; p = 0.006). Limitations include the biases inherent to the retrospective study design.CONCLUSIONS: Patients with recHR-NMIBC and primHR-MIBC had similar survival outcomes, while those with sec-MIBC had the worst outcomes. Therefore, early radical intervention may be indicated in selected patients, and potentially neoadjuvant systemic therapies in some patients with recHR-NMIBC.PATIENT SUMMARY: We compared cancer outcomes in different bladder cancer scenarios in a large, multinational series of patients who underwent removal of the bladder with curative intent. We found that patients who experienced recurrence of non-muscle-invasive bladder cancer (NMIBC) had similar survival outcomes to those with initial muscle-invasive bladder cancer (MIBC), while patients who experienced progression of NMIBC to MIBC had the worst outcomes. Selected patients with non-muscle-invasive disease may benefit from early radical surgery or from perioperative chemotherapy or immunotherapy.",
author = "Grossmann, {Nico C} and Pawel Rajwa and Fahad Quhal and Frederik K{\"o}nig and Hadi Mostafaei and Ekaterina Laukhtina and Keiichiro Mori and Satoshi Katayama and Motlagh, {Reza Sari} and Fankhauser, {Christian D} and Agostino Mattei and Marco Moschini and Piotr Chlosta and {van Rhijn}, {Bas W G} and Teoh, {Jeremy Y C} and Eva Comp{\'e}rat and Marek Babjuk and Mohammad Abufaraj and Karakiewicz, {Pierre I} and Shariat, {Shahrokh F} and Benjamin Pradere",
note = "{\textcopyright} 2022 The Author(s).",
year = "2022",
month = may,
doi = "10.1016/j.euros.2022.02.011",
language = "English",
volume = "39",
pages = "14--21",
journal = "EUR UROL OPEN SCI",
issn = "2666-1691",
publisher = "Elsevier BV",

}

RIS

TY - JOUR

T1 - Comparative Outcomes of Primary Versus Recurrent High-risk Non-muscle-invasive and Primary Versus Secondary Muscle-invasive Bladder Cancer After Radical Cystectomy: Results from a Retrospective Multicenter Study

AU - Grossmann, Nico C

AU - Rajwa, Pawel

AU - Quhal, Fahad

AU - König, Frederik

AU - Mostafaei, Hadi

AU - Laukhtina, Ekaterina

AU - Mori, Keiichiro

AU - Katayama, Satoshi

AU - Motlagh, Reza Sari

AU - Fankhauser, Christian D

AU - Mattei, Agostino

AU - Moschini, Marco

AU - Chlosta, Piotr

AU - van Rhijn, Bas W G

AU - Teoh, Jeremy Y C

AU - Compérat, Eva

AU - Babjuk, Marek

AU - Abufaraj, Mohammad

AU - Karakiewicz, Pierre I

AU - Shariat, Shahrokh F

AU - Pradere, Benjamin

N1 - © 2022 The Author(s).

PY - 2022/5

Y1 - 2022/5

N2 - BACKGROUND: Radical cystectomy (RC) is indicated in primary or secondary muscle-invasive bladder cancer (primMIBC, secMIBC) and in primary or recurrent high- or very high-risk non-muscle-invasive bladder cancer (primHR-NMIBC, recHR-NMIBC). The optimal timing for RC along the disease spectrum of nonmetastatic urothelial carcinoma remains unclear.OBJECTIVE: To compare outcomes after RC between patients with primHR-NMIBC, recHR-NMIBC, primMIBC, and secMIBC.DESIGN SETTING AND PARTICIPANTS: This retrospective, multicenter study included patients with clinically nonmetastatic bladder cancer (BC) treated with RC.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We assessed oncological outcomes for patients who underwent RC according to the natural history of their BC. primHR-NMIBC and primMIBC were defined as no prior history of BC, and recHR-NMIBC and secMIBC as previously treated NMIBC that recurred or progressed to MIBC, respectively. Log-rank analysis was used to compare survival outcomes, and univariable and multivariable Cox and logistic regression analyses were used to identify predictors for survival.RESULTS AND LIMITATIONS: Among the 908 patients included, 211 (23%) had primHR-NMIBC, 125 (14%) had recHR-NMIBC, 404 (44%) had primMIBC, and 168 (19%) had secMIBC. Lymph node involvement and pathological upstaging were more frequent in the secMIBC group than in the other groups (p < 0.001). The median follow-up was 37 mo. The 5-year recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) were 77.9%, 83.2%, and 72.7% in primHR-NMIBC, 60.0%, 59%, and 48.9% in recHR-NMIBC, 60.9%, 64.5%, and 54.8% in primMIBC, and 41.3%, 46.5%, and 39% in secMIBC, respectively, with statistically significant differences across all survival outcomes except between recHR-NMIBC and primMIBC. On multivariable Cox regression, recHR-NMIBC was independently associated with shorter RFS (hazard ratio [HR] 1.64; p = 0.03), CSS (HR 1.79; p = 0.01), and OS (HR 1.45; p = 0.03), and secMIBC was associated with shorter CSS (HR 1.77; p = 0.01) and OS (HR 1.57; p = 0.006). Limitations include the biases inherent to the retrospective study design.CONCLUSIONS: Patients with recHR-NMIBC and primHR-MIBC had similar survival outcomes, while those with sec-MIBC had the worst outcomes. Therefore, early radical intervention may be indicated in selected patients, and potentially neoadjuvant systemic therapies in some patients with recHR-NMIBC.PATIENT SUMMARY: We compared cancer outcomes in different bladder cancer scenarios in a large, multinational series of patients who underwent removal of the bladder with curative intent. We found that patients who experienced recurrence of non-muscle-invasive bladder cancer (NMIBC) had similar survival outcomes to those with initial muscle-invasive bladder cancer (MIBC), while patients who experienced progression of NMIBC to MIBC had the worst outcomes. Selected patients with non-muscle-invasive disease may benefit from early radical surgery or from perioperative chemotherapy or immunotherapy.

AB - BACKGROUND: Radical cystectomy (RC) is indicated in primary or secondary muscle-invasive bladder cancer (primMIBC, secMIBC) and in primary or recurrent high- or very high-risk non-muscle-invasive bladder cancer (primHR-NMIBC, recHR-NMIBC). The optimal timing for RC along the disease spectrum of nonmetastatic urothelial carcinoma remains unclear.OBJECTIVE: To compare outcomes after RC between patients with primHR-NMIBC, recHR-NMIBC, primMIBC, and secMIBC.DESIGN SETTING AND PARTICIPANTS: This retrospective, multicenter study included patients with clinically nonmetastatic bladder cancer (BC) treated with RC.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We assessed oncological outcomes for patients who underwent RC according to the natural history of their BC. primHR-NMIBC and primMIBC were defined as no prior history of BC, and recHR-NMIBC and secMIBC as previously treated NMIBC that recurred or progressed to MIBC, respectively. Log-rank analysis was used to compare survival outcomes, and univariable and multivariable Cox and logistic regression analyses were used to identify predictors for survival.RESULTS AND LIMITATIONS: Among the 908 patients included, 211 (23%) had primHR-NMIBC, 125 (14%) had recHR-NMIBC, 404 (44%) had primMIBC, and 168 (19%) had secMIBC. Lymph node involvement and pathological upstaging were more frequent in the secMIBC group than in the other groups (p < 0.001). The median follow-up was 37 mo. The 5-year recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) were 77.9%, 83.2%, and 72.7% in primHR-NMIBC, 60.0%, 59%, and 48.9% in recHR-NMIBC, 60.9%, 64.5%, and 54.8% in primMIBC, and 41.3%, 46.5%, and 39% in secMIBC, respectively, with statistically significant differences across all survival outcomes except between recHR-NMIBC and primMIBC. On multivariable Cox regression, recHR-NMIBC was independently associated with shorter RFS (hazard ratio [HR] 1.64; p = 0.03), CSS (HR 1.79; p = 0.01), and OS (HR 1.45; p = 0.03), and secMIBC was associated with shorter CSS (HR 1.77; p = 0.01) and OS (HR 1.57; p = 0.006). Limitations include the biases inherent to the retrospective study design.CONCLUSIONS: Patients with recHR-NMIBC and primHR-MIBC had similar survival outcomes, while those with sec-MIBC had the worst outcomes. Therefore, early radical intervention may be indicated in selected patients, and potentially neoadjuvant systemic therapies in some patients with recHR-NMIBC.PATIENT SUMMARY: We compared cancer outcomes in different bladder cancer scenarios in a large, multinational series of patients who underwent removal of the bladder with curative intent. We found that patients who experienced recurrence of non-muscle-invasive bladder cancer (NMIBC) had similar survival outcomes to those with initial muscle-invasive bladder cancer (MIBC), while patients who experienced progression of NMIBC to MIBC had the worst outcomes. Selected patients with non-muscle-invasive disease may benefit from early radical surgery or from perioperative chemotherapy or immunotherapy.

U2 - 10.1016/j.euros.2022.02.011

DO - 10.1016/j.euros.2022.02.011

M3 - SCORING: Journal article

C2 - 35528782

VL - 39

SP - 14

EP - 21

JO - EUR UROL OPEN SCI

JF - EUR UROL OPEN SCI

SN - 2666-1691

ER -