Giuseppe Rosiello1,2, Sophie Knipper1,3, Carlotta Palumbo1,4, Angela Pecoraro1,5, Stefano Luzzago1,6, Marina Deuker1,7, Lara F Stolzenbach1,3, Zhe Tian1, Andrea Gallina2, Giorgio Gandaglia2, Francesco Montorsi2, Shahrokh F Shariat8,9, Fred Saad1, Alberto Briganti2, Pierre I Karakiewicz1. 1. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada. 2. Division of Experimental Oncology, Department of Urology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy. 3. Department of Urology, Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 4. Urology Unit, ASST Spedali Civili of Brescia, Department of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Brescia, Italy. 5. Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy. 6. Department of Urology, European Institute of Oncology, Milan, Italy. 7. Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany. 8. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. 9. Department of Urology, Institute of Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
Abstract
BACKGROUND AND OBJECTIVES: To investigate other-cause mortality (OCM) rates over time according to several baseline characteristics in bladder cancer (BCa) patients treated with radical cystectomy (RC). METHODS: Within the Surveillance, Epidemiology, and End Results database (1988-2011), we identified 7702 T1-2 N0 M0 urothelial BCa patients treated with RC. Temporal trends and multivariable Cox regression (MCR) analyses assessed 5-year OCM. Data were stratified according to the year of diagnosis (1988-1995 vs 1996-2000 vs 2001-2004 vs 2005-2008 vs 2009-2011), age group (<60 vs 60-75 vs >75 years), sex, race, marital status, and socioeconomic status. RESULTS: Overall, OCM rates decreased from 13.9% in 1988-1995 to 8.6% in 2009-2011. The greatest decrease was recorded in elderly (>75) patients (32%-16%, slope: -0.55% per year; P = .01), followed by patients aged 60 to 75 (21%-5%, slope: -0.35% per year; P = .01), unmarried patients (16%-10%, slope: -0.26% per year; P < .001), male patients (14%-8.9%, slope: -0.23% per year), and African Americans (16%-11%, slope: -0.27% per year; P < .001). MCR models corroborated these results. CONCLUSIONS: Most important decrease in OCM after RC over the last decades was recorded in the elderly, unmarried, and male patients. Nonetheless, these three patient groups still represent ideal targets for efforts aimed at minimizing the morbidity and mortality after RC, as their risk of OCM is higher than in others.
BACKGROUND AND OBJECTIVES: To investigate other-cause mortality (OCM) rates over time according to several baseline characteristics in bladder cancer (BCa) patients treated with radical cystectomy (RC). METHODS: Within the Surveillance, Epidemiology, and End Results database (1988-2011), we identified 7702 T1-2 N0 M0 urothelial BCapatients treated with RC. Temporal trends and multivariable Cox regression (MCR) analyses assessed 5-year OCM. Data were stratified according to the year of diagnosis (1988-1995 vs 1996-2000 vs 2001-2004 vs 2005-2008 vs 2009-2011), age group (<60 vs 60-75 vs >75 years), sex, race, marital status, and socioeconomic status. RESULTS: Overall, OCM rates decreased from 13.9% in 1988-1995 to 8.6% in 2009-2011. The greatest decrease was recorded in elderly (>75) patients (32%-16%, slope: -0.55% per year; P = .01), followed by patients aged 60 to 75 (21%-5%, slope: -0.35% per year; P = .01), unmarried patients (16%-10%, slope: -0.26% per year; P < .001), male patients (14%-8.9%, slope: -0.23% per year), and African Americans (16%-11%, slope: -0.27% per year; P < .001). MCR models corroborated these results. CONCLUSIONS: Most important decrease in OCM after RC over the last decades was recorded in the elderly, unmarried, and male patients. Nonetheless, these three patient groups still represent ideal targets for efforts aimed at minimizing the morbidity and mortality after RC, as their risk of OCM is higher than in others.
Authors: Michael Froehner; Rainer Koch; Ulrike Heberling; Angelika Borkowetz; Matthias Hübler; Vladimir Novotny; Manfred P Wirth; Christian Thomas Journal: Eur Urol Open Sci Date: 2021-05-18