OBJECTIVE: To address the overarching question whether chemoradiation therapy (CMT) offers overall survival (OS) similar to that of radical cystectomy (RC) in muscle-invasive bladder cancer (MIBC), we performed analyses using the National Cancer Database. MATERIALS AND METHODS: Patients diagnosed with MIBC in 2004-2014 who underwent RC or received primary CMT were identified in the National Cancer Database. Survival was estimated using the weighted Kaplan-Meier method, and propensity score-weighted Cox proportional hazards model were used to evaluate association of clinicopathologic features with outcome. RESULTS: Of 484,367 patients with a diagnosis of bladder cancer, 35,856 underwent RC and 4050 received CMT. After applying the exclusion/inclusion criteria, data for 15,854 patients who underwent RC and 2083 who received CMT were available for analysis. Five-year OS was 40.4% in the RC group and 29.4% in the CMT group (P <.001). OS was significantly shorter in the CMT group than in the RC group in both multivariate analysis (hazards ratio [HR] 1.15, 95% CI 1.08-1.22; P <.001) and propensity score-weighted analysis (HR 1.18, 95% CI 1.07-1.30; P <.001). Interaction terms indicated better survival after RC in patients younger than 70 years (HR 1.61, 95% CI 1.34-1.93; P <.001); subgroup analyses identified a survival benefit in patients with N0/N1 disease who underwent RC (HR 1.21, 95% CI 1.09-1.33; P <.001). CONCLUSION AND RELEVANCE: OS after 1 year of treatment was increased in RC group compared to CMT group in patient with MIBC. Further studies are required to identify optimal treatment for specific patients.
OBJECTIVE: To address the overarching question whether chemoradiation therapy (CMT) offers overall survival (OS) similar to that of radical cystectomy (RC) in muscle-invasive bladder cancer (MIBC), we performed analyses using the National Cancer Database. MATERIALS AND METHODS:Patients diagnosed with MIBC in 2004-2014 who underwent RC or received primary CMT were identified in the National Cancer Database. Survival was estimated using the weighted Kaplan-Meier method, and propensity score-weighted Cox proportional hazards model were used to evaluate association of clinicopathologic features with outcome. RESULTS: Of 484,367 patients with a diagnosis of bladder cancer, 35,856 underwent RC and 4050 received CMT. After applying the exclusion/inclusion criteria, data for 15,854 patients who underwent RC and 2083 who received CMT were available for analysis. Five-year OS was 40.4% in the RC group and 29.4% in the CMT group (P <.001). OS was significantly shorter in the CMT group than in the RC group in both multivariate analysis (hazards ratio [HR] 1.15, 95% CI 1.08-1.22; P <.001) and propensity score-weighted analysis (HR 1.18, 95% CI 1.07-1.30; P <.001). Interaction terms indicated better survival after RC in patients younger than 70 years (HR 1.61, 95% CI 1.34-1.93; P <.001); subgroup analyses identified a survival benefit in patients with N0/N1 disease who underwent RC (HR 1.21, 95% CI 1.09-1.33; P <.001). CONCLUSION AND RELEVANCE: OS after 1 year of treatment was increased in RC group compared to CMT group in patient with MIBC. Further studies are required to identify optimal treatment for specific patients.
Authors: Soko Setoguchi; Sebastian Schneeweiss; M Alan Brookhart; Robert J Glynn; E Francis Cook Journal: Pharmacoepidemiol Drug Saf Date: 2008-06 Impact factor: 2.890
Authors: Jason A Efstathiou; Daphna Y Spiegel; William U Shipley; Niall M Heney; Donald S Kaufman; Andrzej Niemierko; John J Coen; Rafi Y Skowronski; Jonathan J Paly; Francis J McGovern; Anthony L Zietman Journal: Eur Urol Date: 2011-11-12 Impact factor: 20.096
Authors: Nicholas P Munro; Subramnian K Sundaram; Philip M T Weston; Lesley Fairley; Simon C W Harrison; David Forman; Rohit Chahal Journal: Int J Radiat Oncol Biol Phys Date: 2009-08-06 Impact factor: 7.038
Authors: Justin E Bekelman; Elizabeth A Handorf; Thomas Guzzo; Craig Evan Pollack; John Christodouleas; Matthew J Resnick; Samuel Swisher-McClure; David Vaughn; Thomas Ten Have; Daniel Polsky; Nandita Mitra Journal: Value Health Date: 2013-04-24 Impact factor: 5.725
Authors: Ofer N Gofrit; Rony Nof; Amichai Meirovitz; Dov Pode; Stephen Frank; Ran Katz; Amos Shapiro; Ezekiel H Landau; Guy Hidas; Vladimir Yutkin; Mordechai Duvdevani; Mark Wygoda Journal: Urol Oncol Date: 2014-11-04 Impact factor: 3.498
Authors: David B Cahn; Elizabeth A Handorf; Eric M Ghiraldi; Benjamin T Ristau; Daniel M Geynisman; Thomas M Churilla; Eric M Horwitz; Mark L Sobczak; David Y T Chen; Rosalia Viterbo; Richard E Greenberg; Alexander Kutikov; Robert G Uzzo; Marc C Smaldone Journal: Cancer Date: 2017-07-25 Impact factor: 6.860
Authors: Philippe E Spiess; Neeraj Agarwal; Rick Bangs; Stephen A Boorjian; Mark K Buyyounouski; Peter E Clark; Tracy M Downs; Jason A Efstathiou; Thomas W Flaig; Terence Friedlander; Richard E Greenberg; Khurshid A Guru; Noah Hahn; Harry W Herr; Christopher Hoimes; Brant A Inman; Masahito Jimbo; A Karim Kader; Subodh M Lele; Joshua J Meeks; Jeff Michalski; Jeffrey S Montgomery; Lance C Pagliaro; Sumanta K Pal; Anthony Patterson; Elizabeth R Plimack; Kamal S Pohar; Michael P Porter; Mark A Preston; Wade J Sexton; Arlene O Siefker-Radtke; Guru Sonpavde; Jonathan Tward; Geoffrey Wile; Mary A Dwyer; Lisa A Gurski Journal: J Natl Compr Canc Netw Date: 2017-10 Impact factor: 11.908
Authors: Matthew B Clements; Thomas M Atkinson; Guido M Dalbagni; Yuelin Li; Andrew J Vickers; Harry W Herr; S Machele Donat; Jaspreet S Sandhu; Daniel S Sjoberg; Amy L Tin; Bruce D Rapkin; Bernard H Bochner Journal: Eur Urol Date: 2021-10-08 Impact factor: 20.096
Authors: Dharam Kaushik; Zheng Shi; Michael A Liss; Hanzhang Wang; Richa Priya Jha; Byeong Yeob Choi; Deepak K Pruthi; Chul S Ha; Ahmed M Mansour; Robert S Svatek Journal: Urol Oncol Date: 2019-10-29 Impact factor: 3.498