Survival benefit of chemotherapy in a contemporary cohort of metastatic urachal carcinoma
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Survival benefit of chemotherapy in a contemporary cohort of metastatic urachal carcinoma. / Flammia, Rocco Simone; Chierigo, Francesco; Würnschimmel, Christoph; Horlemann, Benedikt; Hoeh, Benedikt; Sorce, Gabriele; Tian, Zhen; Leonardo, Costantino; Tilki, Derya; Terrone, Carlo; Saad, Fred; Shariat, Shahrokh F; Montorsi, Francesco; Chun, Felix Kh; Gallucci, Michele; Karakiewicz, Pierre I.
In: UROL ONCOL-SEMIN ORI, Vol. 40, No. 4, 04.2022, p. 165.e9-165.e15.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Survival benefit of chemotherapy in a contemporary cohort of metastatic urachal carcinoma
AU - Flammia, Rocco Simone
AU - Chierigo, Francesco
AU - Würnschimmel, Christoph
AU - Horlemann, Benedikt
AU - Hoeh, Benedikt
AU - Sorce, Gabriele
AU - Tian, Zhen
AU - Leonardo, Costantino
AU - Tilki, Derya
AU - Terrone, Carlo
AU - Saad, Fred
AU - Shariat, Shahrokh F
AU - Montorsi, Francesco
AU - Chun, Felix Kh
AU - Gallucci, Michele
AU - Karakiewicz, Pierre I
N1 - Copyright © 2021 Elsevier Inc. All rights reserved.
PY - 2022/4
Y1 - 2022/4
N2 - BACKGROUND: We relied on the most contemporary Surveillance, Epidemiology, and End Results (SEER) database and tested the hypothesis that chemotherapy may improve survival in metastatic urachal carcinoma (m-UraC).MATERIAL AND METHODS: Within the SEER database (2004-2016), we identified m-UraC patients aged ≥ 18 years. Propensity score matching (PSM: cystectomy status, age and sex), Kaplan-Meier plots, cumulative incidence plots, Cox regression models and competing risks regression (CRR) models addressed overall mortality (OM) and cancer-specific mortality (CSM).RESULTS: Overall, 274 m-UraC patients were identified with a median age of 70 years. Most were male (66%) and Caucasian (72%). Overall, 32% received chemotherapy. Chemotherapy-exposed patients were younger (62 vs. 73 years, p<0.001) and more frequently underwent cystectomy (19 vs. 8%, P = 0.014). In 274 m-UraC patients, median OM and CSM were 6 (4 -10) months and 8 (6 -14) months, respectively. After 1:1 PSM, chemotherapy-exposed patients exhibited lower OM (median 16 vs. 3 months; multivariable HR 0.38, P <0.001) and lower CSM (median 17 vs. 4 months; multivariable CRR HR 0.52, P = 0.001). The association between chemotherapy and better survival was even stronger in younger (≤70 years) patients (OM HR: 0.23, P <0.001; CSM CRR HR: 0.42, P = 0.001), but not in older (≥71 years) patients (OM HR: 0.61, P = 0.2; CSM CRR HR: 1.02, P = 1), after PSM and multivariable adjustments.CONCLUSION: Overall, we validated the very aggressive nature of UraC, when distant metastases are present, and observed that m-UraC patients exposed to chemotherapy exhibited lower OM and CSM.
AB - BACKGROUND: We relied on the most contemporary Surveillance, Epidemiology, and End Results (SEER) database and tested the hypothesis that chemotherapy may improve survival in metastatic urachal carcinoma (m-UraC).MATERIAL AND METHODS: Within the SEER database (2004-2016), we identified m-UraC patients aged ≥ 18 years. Propensity score matching (PSM: cystectomy status, age and sex), Kaplan-Meier plots, cumulative incidence plots, Cox regression models and competing risks regression (CRR) models addressed overall mortality (OM) and cancer-specific mortality (CSM).RESULTS: Overall, 274 m-UraC patients were identified with a median age of 70 years. Most were male (66%) and Caucasian (72%). Overall, 32% received chemotherapy. Chemotherapy-exposed patients were younger (62 vs. 73 years, p<0.001) and more frequently underwent cystectomy (19 vs. 8%, P = 0.014). In 274 m-UraC patients, median OM and CSM were 6 (4 -10) months and 8 (6 -14) months, respectively. After 1:1 PSM, chemotherapy-exposed patients exhibited lower OM (median 16 vs. 3 months; multivariable HR 0.38, P <0.001) and lower CSM (median 17 vs. 4 months; multivariable CRR HR 0.52, P = 0.001). The association between chemotherapy and better survival was even stronger in younger (≤70 years) patients (OM HR: 0.23, P <0.001; CSM CRR HR: 0.42, P = 0.001), but not in older (≥71 years) patients (OM HR: 0.61, P = 0.2; CSM CRR HR: 1.02, P = 1), after PSM and multivariable adjustments.CONCLUSION: Overall, we validated the very aggressive nature of UraC, when distant metastases are present, and observed that m-UraC patients exposed to chemotherapy exhibited lower OM and CSM.
U2 - 10.1016/j.urolonc.2021.09.008
DO - 10.1016/j.urolonc.2021.09.008
M3 - SCORING: Journal article
C2 - 34686429
VL - 40
SP - 165.e9-165.e15
JO - UROL ONCOL-SEMIN ORI
JF - UROL ONCOL-SEMIN ORI
SN - 1078-1439
IS - 4
ER -
