OBJECTIVE: • To examine cancer-specific mortality (CSM) in patients with pT4N₀₋₃ M₀ urothelial carcinoma of the urinary bladder (UCUB) and to compare it to patients with pT3N₀₋₃ M₀, in a population-based cohort treated with radical cystectomy (RC). PATIENTS AND METHODS: • RCs were performed in 5625 pT3-T4b₀₋₃ M₀ patients with UCUB within 17 Surveillance, Epidemiology and End Results (SEER) registries between 1988 and 2006. • Univariable and multivariable models tested the effect of pT4a vs pT4b vs pT3 stages on CSM. • Covariates consisted of age, gender, race, lymph node status and SEER registries. • All analyses were repeated in 3635 pN(0) patients. RESULTS: • Of 5625 patients, 2043 (36.3%) had pT4aN₀₋₃ , 248 (4.4%) had pT4bN₀₋₃ and 3334 had pT3N₀₋₃ (59.3%) UCUB. • The 5-year CSM was 57.6% vs 81.7% vs 53.9% for, respectively, pT4aN₀₋₃ vs pT4bN₀₋₃ vs pT3N₀₋₃ patients (all log-rank P= 0.008). • In multivariable analyses the rate of CSM was 2.3-fold higher in pT4b vs pT3 (P < 0.001), 1.1-fold higher in pT4a vs pT3 (P= 0.002) and 2.0-fold higher in pT4a vs pT4b patients. • After restriction to pN₀ stage, pT4b patients had a 2.3-fold higher rate of CSM than pT3 patients (P < 0.001) and pT4b patients had a 2.1-fold higher rate of CSM than pT4a patients (P < 0.001). • The CSM rate was the same for pT4a and pT3 patients (P= 0.1). CONCLUSIONS: • Our findings indicate that patients with pT4a UCUB have similar CSM as those with pT3 UCUB. • Consequently, RC should be given equal consideration in patients with pT3 and pT4a UCUB.
OBJECTIVE: • To examine cancer-specific mortality (CSM) in patients with pT4N₀₋₃ M₀ urothelial carcinoma of the urinary bladder (UCUB) and to compare it to patients with pT3N₀₋₃ M₀, in a population-based cohort treated with radical cystectomy (RC). PATIENTS AND METHODS: • RCs were performed in 5625 pT3-T4b₀₋₃ M₀ patients with UCUB within 17 Surveillance, Epidemiology and End Results (SEER) registries between 1988 and 2006. • Univariable and multivariable models tested the effect of pT4a vs pT4b vs pT3 stages on CSM. • Covariates consisted of age, gender, race, lymph node status and SEER registries. • All analyses were repeated in 3635 pN(0) patients. RESULTS: • Of 5625 patients, 2043 (36.3%) had pT4aN₀₋₃ , 248 (4.4%) had pT4bN₀₋₃ and 3334 had pT3N₀₋₃ (59.3%) UCUB. • The 5-year CSM was 57.6% vs 81.7% vs 53.9% for, respectively, pT4aN₀₋₃ vs pT4bN₀₋₃ vs pT3N₀₋₃ patients (all log-rank P= 0.008). • In multivariable analyses the rate of CSM was 2.3-fold higher in pT4b vs pT3 (P < 0.001), 1.1-fold higher in pT4a vs pT3 (P= 0.002) and 2.0-fold higher in pT4a vs pT4b patients. • After restriction to pN₀ stage, pT4b patients had a 2.3-fold higher rate of CSM than pT3 patients (P < 0.001) and pT4b patients had a 2.1-fold higher rate of CSM than pT4a patients (P < 0.001). • The CSM rate was the same for pT4a and pT3 patients (P= 0.1). CONCLUSIONS: • Our findings indicate that patients with pT4a UCUB have similar CSM as those with pT3 UCUB. • Consequently, RC should be given equal consideration in patients with pT3 and pT4a UCUB.
Authors: Harun Fajkovic; Joshua A Halpern; Eugene K Cha; Atessa Bahadori; Thomas F Chromecki; Pierre I Karakiewicz; Eckart Breinl; Axel S Merseburger; Shahrokh F Shariat Journal: World J Urol Date: 2011-06-09 Impact factor: 4.226
Authors: Matthias May; Atiqullah Aziz; Sabine Brookman-May; Florian Roghmann; Joachim Noldus; Michael Rink; Felix Chun; Margit Fisch; Vladimir Novotny; Manfred Wirth; Roman Mayr; Armin Pycha; Antonin Brisuda; Björn Volkmer; Regina Stredele; Christopher Dechet; Stefan Vallo; Axel Haferkamp; Marco Schnabel; Stefan Denzinger; Jan Roigas; Christian G Stief; Christian Gilfrich; Patrick J Bastian; Jörg B Engel; Maximilian Burger; Hans-Martin Fritsche Journal: World J Urol Date: 2014-05-10 Impact factor: 4.226
Authors: Marco Moschini; Francesco Soria; Martin Susani; Stephan Korn; Alberto Briganti; Morgan Roupret; Christian Seitz; Killian Gust; Andrea Haitel; Francesco Montorsi; Gregory Wirth; Brian D Robinson; Pierre I Karakiewicz; Mehmet Özsoy; Michael Rink; Shahrokh F Shariat Journal: Bladder Cancer Date: 2017-07-27
Authors: Christian Niedworok; Inga Kretschmer; Katharina Röck; Frank Vom Dorp; Tibor Szarvas; Jochen Heß; Till Freudenberger; Ariane Melchior-Becker; Herbert Rübben; Jens W Fischer Journal: PLoS One Date: 2013-09-17 Impact factor: 3.240