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Differential effect on survival of pelvic lymph node dissection at radical cystectomy for muscle invasive bladder cancer

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Differential effect on survival of pelvic lymph node dissection at radical cystectomy for muscle invasive bladder cancer. / Larcher, A; Sun, M; Schiffmann, J; Tian, Z; Shariat, S F; McCormack, M; Saad, F; Fossati, N; Abdollah, F; Briganti, A; Buffi, N; Graefen, M; Guazzoni, G; Montorsi, F; Karakiewicz, P I.

In: EJSO-EUR J SURG ONC, Vol. 41, No. 3, 01.03.2015, p. 353-60.

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

Harvard

Larcher, A, Sun, M, Schiffmann, J, Tian, Z, Shariat, SF, McCormack, M, Saad, F, Fossati, N, Abdollah, F, Briganti, A, Buffi, N, Graefen, M, Guazzoni, G, Montorsi, F & Karakiewicz, PI 2015, 'Differential effect on survival of pelvic lymph node dissection at radical cystectomy for muscle invasive bladder cancer', EJSO-EUR J SURG ONC, vol. 41, no. 3, pp. 353-60. https://doi.org/10.1016/j.ejso.2014.10.061

APA

Larcher, A., Sun, M., Schiffmann, J., Tian, Z., Shariat, S. F., McCormack, M., Saad, F., Fossati, N., Abdollah, F., Briganti, A., Buffi, N., Graefen, M., Guazzoni, G., Montorsi, F., & Karakiewicz, P. I. (2015). Differential effect on survival of pelvic lymph node dissection at radical cystectomy for muscle invasive bladder cancer. EJSO-EUR J SURG ONC, 41(3), 353-60. https://doi.org/10.1016/j.ejso.2014.10.061

Vancouver

Larcher A, Sun M, Schiffmann J, Tian Z, Shariat SF, McCormack M et al. Differential effect on survival of pelvic lymph node dissection at radical cystectomy for muscle invasive bladder cancer. EJSO-EUR J SURG ONC. 2015 Mar 1;41(3):353-60. https://doi.org/10.1016/j.ejso.2014.10.061

Bibtex

@article{75a060c190cc40aba3f2cdaf054d4f1f,
title = "Differential effect on survival of pelvic lymph node dissection at radical cystectomy for muscle invasive bladder cancer",
abstract = "PURPOSE: To compare long-term cancer outcomes after radical cystectomy (RC) alone or RC with pelvic lymph node dissection (PLND) according to different age and comorbidities categories.METHODS: Using the SEER-Medicare dataset, 3314 patients diagnosed with urothelial carcinoma of the urinary bladder and treated with RC alone or RC with PLND were identified. After propensity score matching to reduce potential selection bias, all cause mortality (ACM)-free and cancer specific mortality (CSM)-free survival rates were estimated. Multivariable regression models (MVA) addressed the effect of PLND on ACM and CSM. Subgroups analyses according to age and comorbidities were performed.RESULTS: After matching, 688 and 688 patients treated with RC alone or RC with PLND remained. The 5-year ACM-free survival rate was 36 after RC alone and 45% after RC with PLND (p < 0001). In MVA, PLND exerted a protective effect on ACM (HR 0.77, p < 0.001). The 5-year CSM-free survival rate was 54 after RC alone and 65% after RC with PLND (p < 0.001). In MVA, PLND exerted a protective effect on CSM (HR 0.71, p < 0.001). Similar results were observed in younger (age ≤75) and healthier (CCI = 0) patients, where PLND exerted a protective effect on ACM (HR 0.64, p = 0.001) and CSM (HR 0.65, p = 0.01). Conversely, in older (age >75) and sicker (CCI ≥1) patients, PLND was not associated with ACM (HR 0.98, p = 0.8) or CSM (HR 1.01, p = 0.9).CONCLUSIONS: RC with PLND is associated with improved all cause and cancer specific survival in younger and healthier RC candidates but not in older and sicker patients.",
keywords = "Aged, Aged, 80 and over, Carcinoma, Transitional Cell, Cohort Studies, Cystectomy, Databases, Factual, Disease-Free Survival, Female, Humans, Lymph Node Excision, Lymph Nodes, Male, Neoplasm Invasiveness, Pelvis, Prognosis, SEER Program, Treatment Outcome, Urinary Bladder, Urinary Bladder Neoplasms",
author = "A Larcher and M Sun and J Schiffmann and Z Tian and Shariat, {S F} and M McCormack and F Saad and N Fossati and F Abdollah and A Briganti and N Buffi and M Graefen and G Guazzoni and F Montorsi and Karakiewicz, {P I}",
note = "Copyright {\textcopyright} 2014 Elsevier Ltd. All rights reserved.",
year = "2015",
month = mar,
day = "1",
doi = "10.1016/j.ejso.2014.10.061",
language = "English",
volume = "41",
pages = "353--60",
journal = "EJSO-EUR J SURG ONC",
issn = "0748-7983",
publisher = "W.B. Saunders Ltd",
number = "3",

}

RIS

TY - JOUR

T1 - Differential effect on survival of pelvic lymph node dissection at radical cystectomy for muscle invasive bladder cancer

AU - Larcher, A

AU - Sun, M

AU - Schiffmann, J

AU - Tian, Z

AU - Shariat, S F

AU - McCormack, M

AU - Saad, F

AU - Fossati, N

AU - Abdollah, F

AU - Briganti, A

AU - Buffi, N

AU - Graefen, M

AU - Guazzoni, G

AU - Montorsi, F

AU - Karakiewicz, P I

N1 - Copyright © 2014 Elsevier Ltd. All rights reserved.

PY - 2015/3/1

Y1 - 2015/3/1

N2 - PURPOSE: To compare long-term cancer outcomes after radical cystectomy (RC) alone or RC with pelvic lymph node dissection (PLND) according to different age and comorbidities categories.METHODS: Using the SEER-Medicare dataset, 3314 patients diagnosed with urothelial carcinoma of the urinary bladder and treated with RC alone or RC with PLND were identified. After propensity score matching to reduce potential selection bias, all cause mortality (ACM)-free and cancer specific mortality (CSM)-free survival rates were estimated. Multivariable regression models (MVA) addressed the effect of PLND on ACM and CSM. Subgroups analyses according to age and comorbidities were performed.RESULTS: After matching, 688 and 688 patients treated with RC alone or RC with PLND remained. The 5-year ACM-free survival rate was 36 after RC alone and 45% after RC with PLND (p < 0001). In MVA, PLND exerted a protective effect on ACM (HR 0.77, p < 0.001). The 5-year CSM-free survival rate was 54 after RC alone and 65% after RC with PLND (p < 0.001). In MVA, PLND exerted a protective effect on CSM (HR 0.71, p < 0.001). Similar results were observed in younger (age ≤75) and healthier (CCI = 0) patients, where PLND exerted a protective effect on ACM (HR 0.64, p = 0.001) and CSM (HR 0.65, p = 0.01). Conversely, in older (age >75) and sicker (CCI ≥1) patients, PLND was not associated with ACM (HR 0.98, p = 0.8) or CSM (HR 1.01, p = 0.9).CONCLUSIONS: RC with PLND is associated with improved all cause and cancer specific survival in younger and healthier RC candidates but not in older and sicker patients.

AB - PURPOSE: To compare long-term cancer outcomes after radical cystectomy (RC) alone or RC with pelvic lymph node dissection (PLND) according to different age and comorbidities categories.METHODS: Using the SEER-Medicare dataset, 3314 patients diagnosed with urothelial carcinoma of the urinary bladder and treated with RC alone or RC with PLND were identified. After propensity score matching to reduce potential selection bias, all cause mortality (ACM)-free and cancer specific mortality (CSM)-free survival rates were estimated. Multivariable regression models (MVA) addressed the effect of PLND on ACM and CSM. Subgroups analyses according to age and comorbidities were performed.RESULTS: After matching, 688 and 688 patients treated with RC alone or RC with PLND remained. The 5-year ACM-free survival rate was 36 after RC alone and 45% after RC with PLND (p < 0001). In MVA, PLND exerted a protective effect on ACM (HR 0.77, p < 0.001). The 5-year CSM-free survival rate was 54 after RC alone and 65% after RC with PLND (p < 0.001). In MVA, PLND exerted a protective effect on CSM (HR 0.71, p < 0.001). Similar results were observed in younger (age ≤75) and healthier (CCI = 0) patients, where PLND exerted a protective effect on ACM (HR 0.64, p = 0.001) and CSM (HR 0.65, p = 0.01). Conversely, in older (age >75) and sicker (CCI ≥1) patients, PLND was not associated with ACM (HR 0.98, p = 0.8) or CSM (HR 1.01, p = 0.9).CONCLUSIONS: RC with PLND is associated with improved all cause and cancer specific survival in younger and healthier RC candidates but not in older and sicker patients.

KW - Aged

KW - Aged, 80 and over

KW - Carcinoma, Transitional Cell

KW - Cohort Studies

KW - Cystectomy

KW - Databases, Factual

KW - Disease-Free Survival

KW - Female

KW - Humans

KW - Lymph Node Excision

KW - Lymph Nodes

KW - Male

KW - Neoplasm Invasiveness

KW - Pelvis

KW - Prognosis

KW - SEER Program

KW - Treatment Outcome

KW - Urinary Bladder

KW - Urinary Bladder Neoplasms

U2 - 10.1016/j.ejso.2014.10.061

DO - 10.1016/j.ejso.2014.10.061

M3 - SCORING: Journal article

C2 - 25477269

VL - 41

SP - 353

EP - 360

JO - EJSO-EUR J SURG ONC

JF - EJSO-EUR J SURG ONC

SN - 0748-7983

IS - 3

ER -