PURPOSE: We identify clinicopathological variables predicting overall survival in patients with recurrent bladder urothelial carcinoma after radical cystectomy. MATERIALS AND METHODS: We retrospectively collected data on 114 patients treated with radical cystectomy for bladder urothelial carcinoma who subsequently had remote metastasis and/or local recurrence. The Kaplan-Meier method with the log rank test and multivariate Cox regression models were used to address overall survival after recurrence. RESULTS: During followup 99 of the 114 patients died. Median survival in the 114 patients was 11.2 months. One and 3-year overall survival rates were 48.0% and 12.1%, respectively. On multivariate analysis independent predictors of poorer overall survival included less than 1 year to recurrence, symptoms at recurrence, 2 or more metastatic organs at recurrence, high serum C-reactive protein, high lactate dehydrogenase, no post-recurrence platinum based chemotherapy and no metastasectomy. Based on the 4 variables (time to recurrence, symptoms, number of metastatic organs and C-reactive protein), we constructed a risk model predicting post-recurrence overall survival that classified patients into 3 groups with significantly different overall survival (p <0.0001). CONCLUSIONS: Our data confirm that recurrent urothelial carcinoma after radical cystectomy is a highly aggressive, lethal disease. Seven clinicopathological factors were identified that predicted post-recurrence overall survival. Our risk model based on the 4 variables could be useful to provide relevant prognostic information to patients and physicians, and better stratify patients in clinical trials.
PURPOSE: We identify clinicopathological variables predicting overall survival in patients with recurrent bladder urothelial carcinoma after radical cystectomy. MATERIALS AND METHODS: We retrospectively collected data on 114 patients treated with radical cystectomy for bladder urothelial carcinoma who subsequently had remote metastasis and/or local recurrence. The Kaplan-Meier method with the log rank test and multivariate Cox regression models were used to address overall survival after recurrence. RESULTS: During followup 99 of the 114 patients died. Median survival in the 114 patients was 11.2 months. One and 3-year overall survival rates were 48.0% and 12.1%, respectively. On multivariate analysis independent predictors of poorer overall survival included less than 1 year to recurrence, symptoms at recurrence, 2 or more metastatic organs at recurrence, high serum C-reactive protein, high lactate dehydrogenase, no post-recurrence platinum based chemotherapy and no metastasectomy. Based on the 4 variables (time to recurrence, symptoms, number of metastatic organs and C-reactive protein), we constructed a risk model predicting post-recurrence overall survival that classified patients into 3 groups with significantly different overall survival (p <0.0001). CONCLUSIONS: Our data confirm that recurrent urothelial carcinoma after radical cystectomy is a highly aggressive, lethal disease. Seven clinicopathological factors were identified that predicted post-recurrence overall survival. Our risk model based on the 4 variables could be useful to provide relevant prognostic information to patients and physicians, and better stratify patients in clinical trials.
Authors: Vladimir Novotny; Michael Froehner; Matthias May; Chris Protzel; Katrin Hergenröther; Michael Rink; Felix K Chun; Margit Fisch; Florian Roghmann; Rein-Jüri Palisaar; Joachim Noldus; Michael Gierth; Hans-Martin Fritsche; Maximilian Burger; Danijel Sikic; Bastian Keck; Bernd Wullich; Philipp Nuhn; Alexander Buchner; Christian G Stief; Stefan Vallo; Georg Bartsch; Axel Haferkamp; Patrick J Bastian; Oliver W Hakenberg; Stefan Propping; Atiqullah Aziz Journal: World J Urol Date: 2015-02-08 Impact factor: 4.226
Authors: Matteo Ferro; Ottavio De Cobelli; Carlo Buonerba; Giuseppe Di Lorenzo; Marco Capece; Dario Bruzzese; Riccardo Autorino; Danilo Bottero; Antonio Cioffi; Deliu Victor Matei; Michele Caraglia; Marco Borghesi; Ettore De Berardinis; Gian Maria Busetto; Riccardo Giovannone; Giuseppe Lucarelli; Pasquale Ditonno; Sisto Perdonà; Pierluigi Bove; Luigi Castaldo; Rodolfo Hurle; Gennaro Musi; Antonio Brescia; Michele Olivieri; Amelia Cimmino; Vincenzo Altieri; Rocco Damiano; Francesco Cantiello; Vincenzo Serretta; Sabino De Placido; Vincenzo Mirone; Guru Sonpavde; Daniela Terracciano Journal: Medicine (Baltimore) Date: 2015-10 Impact factor: 1.817