Harman Maxim Bruins1, Katja K H Aben2, Tom J Arends3, Antoine G van der Heijden3, Alfred J Witjes3. 1. Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: max.bruins@radboudumc.nl. 2. Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands; Radboud Institute for Health Sciences (RIHS), Radboud University Medical Center, Nijmegen, The Netherlands. 3. Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands.
Abstract
INTRODUCTION: Data from single-center series suggest that a delay in time to radical cystectomy (RC) more than 3 months after diagnosis of muscle-invasive bladder cancer (MIBC) is associated with pathological upstaging and decreased survival. However, limited data is available from population-based studies. In this study, the effect of delayed RC was assessed in a nationwide cohort. MATERIALS AND METHODS: Patients who underwent RC between 2006 and 2010 with primary clinical T2-T4N0M0 urothelial bladder cancer were selected using the Netherlands Cancer Registry database. Data from the Netherlands Cancer Registry was supplemented with data from the Nationwide Network and Registry of Histo- and Cytopathology database in case of incomplete information. The cohort was divided in patients who underwent RC ≤3 months (group I) vs. patients who underwent RC >3 months (group II). Median time from MIBC diagnosis to RC, variables associated with delayed RC >3 and the effect of delayed RC on staging and overall survival (OS) were evaluated in patients who underwent neoadjuvant therapy and patients who did not. RESULTS: A total of 1,782 patients were included. Median follow-up time was 5.1 years for living patients and 1.3 years for deceased patients. Median time from MIBC diagnosis to RC was 50 days (interquartile range: 27 days) and 93% of patients underwent RC≤3 months. Patients older than 75 years (odds ratio [OR] = 0.50; 95% CI: 0.32-0.77), referred for RC (OR = 0.41; 95% CI: 0.26-0.69), and treated in a university hospital (OR = 0.34; 95% CI: 0.21-0.56) were less likely to undergo RC≤3 months. Pathologic upstaging rate (43.9% vs. 42.1%) and node-positive disease rate (20.2% vs. 21.7%) did not differ for group I and II. Delayed RC>3 months was not associated with decreased OS adjusting for confounding variables (hazard ratio = 1.16; 95% CI: 0.91-1.48; P = 0.25). Median time from MIBC diagnosis to RC in patients that received neoadjuvant therapy (n = 105) was 133 days (interquartile range: 62 days). Adjusting for confounding variables, delayed RC>3 months was not associated with OS (hazard ratio = 0.90; 95% CI: 0.45-1.82). CONCLUSIONS: The vast majority of patient underwent RC within 3 months after diagnosis of MIBC, as recommended in the European Association of Urology MIBC guideline. Delayed RC for more than 3 months had no adverse effect on staging and survival.
INTRODUCTION: Data from single-center series suggest that a delay in time to radical cystectomy (RC) more than 3 months after diagnosis of muscle-invasive bladder cancer (MIBC) is associated with pathological upstaging and decreased survival. However, limited data is available from population-based studies. In this study, the effect of delayed RC was assessed in a nationwide cohort. MATERIALS AND METHODS:Patients who underwent RC between 2006 and 2010 with primary clinical T2-T4N0M0 urothelial bladder cancer were selected using the Netherlands Cancer Registry database. Data from the Netherlands Cancer Registry was supplemented with data from the Nationwide Network and Registry of Histo- and Cytopathology database in case of incomplete information. The cohort was divided in patients who underwent RC ≤3 months (group I) vs. patients who underwent RC >3 months (group II). Median time from MIBC diagnosis to RC, variables associated with delayed RC >3 and the effect of delayed RC on staging and overall survival (OS) were evaluated in patients who underwent neoadjuvant therapy and patients who did not. RESULTS: A total of 1,782 patients were included. Median follow-up time was 5.1 years for living patients and 1.3 years for deceased patients. Median time from MIBC diagnosis to RC was 50 days (interquartile range: 27 days) and 93% of patients underwent RC≤3 months. Patients older than 75 years (odds ratio [OR] = 0.50; 95% CI: 0.32-0.77), referred for RC (OR = 0.41; 95% CI: 0.26-0.69), and treated in a university hospital (OR = 0.34; 95% CI: 0.21-0.56) were less likely to undergo RC≤3 months. Pathologic upstaging rate (43.9% vs. 42.1%) and node-positive disease rate (20.2% vs. 21.7%) did not differ for group I and II. Delayed RC>3 months was not associated with decreased OS adjusting for confounding variables (hazard ratio = 1.16; 95% CI: 0.91-1.48; P = 0.25). Median time from MIBC diagnosis to RC in patients that received neoadjuvant therapy (n = 105) was 133 days (interquartile range: 62 days). Adjusting for confounding variables, delayed RC>3 months was not associated with OS (hazard ratio = 0.90; 95% CI: 0.45-1.82). CONCLUSIONS: The vast majority of patient underwent RC within 3 months after diagnosis of MIBC, as recommended in the European Association of Urology MIBC guideline. Delayed RC for more than 3 months had no adverse effect on staging and survival.
Authors: Martijn P A Starmans; Li Shen Ho; Fokko Smits; Nick Beije; Inge de Kruijff; Joep J de Jong; Diederik M Somford; Egbert R Boevé; Ed Te Slaa; Evelyne C C Cauberg; Sjoerd Klaver; Antoine G van der Heijden; Carl J Wijburg; Addy C M van de Luijtgaarden; Harm H E van Melick; Ella Cauffman; Peter de Vries; Rens Jacobs; Wiro J Niessen; Jacob J Visser; Stefan Klein; Joost L Boormans; Astrid A M van der Veldt Journal: J Pers Med Date: 2022-04-30
Authors: Murat Akand; Tim Muilwijk; Jan Cornelissen; Siska Van Bruwaene; Kathy Vander Eeckt; Frederic Baekelandt; Pieter Mattelaer; Raf Van Reusel; Ben Van Cleynenbreugel; Steven Joniau; Frank Van Der Aa Journal: Front Oncol Date: 2019-12-11 Impact factor: 6.244
Authors: Maria Lucia Iacovino; Chiara Carmen Miceli; Marco De Felice; Biagio Barone; Luca Pompella; Francesco Chiancone; Erika Di Zazzo; Giuseppe Tirino; Carminia Maria Della Corte; Ciro Imbimbo; Ferdinando De Vita; Felice Crocetto Journal: Int J Mol Sci Date: 2022-01-20 Impact factor: 5.923