Marina Deuker1, L Franziska Stolzenbach2, Giuseppe Rosiello3, Stefano Luzzago4, Thomas Martin5, Zhe Tian5, Derya Tilki6, Shahrokh F Shariat7, Fred Saad5, Wassim Kassouf8, Peter C Black9, Felix K H Chun10, Pierre I Karakiewicz5. 1. Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada. Electronic address: Marina.Deuker@kgu.de. 2. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 3. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy. 4. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; European Institute of Oncology, Milan, Italy. 5. Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada. 6. Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 7. Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Department of Urology, University of Jordan, Amman, Jordan. 8. Department of Urology, McGill University Health Centre, Montréal, Québec, Canada. 9. Department of Urologic Sciences, Vancouver Prostate Centre, University of British Columbia, Vancouver, British Colombia, Canada. 10. Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany.
Abstract
BACKGROUND: Radical cystectomy (RC) is often performed for T1 variant histology bladder cancer (VHBC), based on weak clinical evidence. We tested for cancer specific survival (CSS) differences after RC between T1 VHBC vs. urothelial carcinoma of the urinary bladder (UBC). METHODS: Within the Surveillance, Epidemiology and End Results registry (SEER, 2001-2016), we retrospectively identified T1N0M0 VHBC (adenocarcinoma, squamous cell carcinoma [SqCC], neuroendocrine carcinoma and other VHBC) and UBC patients. Kaplan-Meier plots, multivariate Cox regression models (CRM) with inverse probability treatment weighting (IPTW) and competing risks regression (CRR) tested CSS rates after RC in stage T1 vs. no-RC according to VHBC type and UBC. RESULTS: Of all 37,528 T1N0M0 bladder cancer patients, 1726 (4.6%) harboured VHBC. Of those, 598 (1.6%) had SqCC, 409 (1.1%) adenocarcinoma, 249 (0.7%) neuroendocrine carcinoma and 470 (1.3%) other VHBC. RC was performed in 7.4-11.0% of VHBC vs. 5.1% of high grade UBC patients. In patients with neuroendocrine and SqCC, RC was associated with higher CSS rates than any other surgical treatment modality (both p ≤ 0.01). Sixty-month CSS was 100% vs. 67% in neuroendocrine and 86% vs. 66% in SqCC in unadjusted analyses and remained statistically significantly higher in multivariate, IPTW adjusted analyses and in multivariate CRR. No difference was recorded for adenocarcinoma or other VHBC types. CONCLUSIONS: RC for stage T1N0M0 VHBC appears to provide a protective effect with respect to CSS in patients with SqCC and neuroendocrine carcinoma, but not in adenocarcinoma or other VHBC.
BACKGROUND: Radical cystectomy (RC) is often performed for T1 variant histology bladder cancer (VHBC), based on weak clinical evidence. We tested for cancer specific survival (CSS) differences after RC between T1 VHBC vs. urothelial carcinoma of the urinary bladder (UBC). METHODS: Within the Surveillance, Epidemiology and End Results registry (SEER, 2001-2016), we retrospectively identified T1N0M0 VHBC (adenocarcinoma, squamous cell carcinoma [SqCC], neuroendocrine carcinoma and other VHBC) and UBCpatients. Kaplan-Meier plots, multivariate Cox regression models (CRM) with inverse probability treatment weighting (IPTW) and competing risks regression (CRR) tested CSS rates after RC in stage T1 vs. no-RC according to VHBC type and UBC. RESULTS: Of all 37,528 T1N0M0 bladder cancerpatients, 1726 (4.6%) harboured VHBC. Of those, 598 (1.6%) had SqCC, 409 (1.1%) adenocarcinoma, 249 (0.7%) neuroendocrine carcinoma and 470 (1.3%) other VHBC. RC was performed in 7.4-11.0% of VHBC vs. 5.1% of high grade UBCpatients. In patients with neuroendocrine and SqCC, RC was associated with higher CSS rates than any other surgical treatment modality (both p ≤ 0.01). Sixty-month CSS was 100% vs. 67% in neuroendocrine and 86% vs. 66% in SqCC in unadjusted analyses and remained statistically significantly higher in multivariate, IPTW adjusted analyses and in multivariate CRR. No difference was recorded for adenocarcinoma or other VHBC types. CONCLUSIONS: RC for stage T1N0M0 VHBC appears to provide a protective effect with respect to CSS in patients with SqCC and neuroendocrine carcinoma, but not in adenocarcinoma or other VHBC.
Authors: Chiara Lonati; Luca Afferi; Andrea Mari; Andrea Minervini; Wojciech Krajewski; Marco Borghesi; Gerald B Schulz; Michael Rink; Francesco Montorsi; Alberto Briganti; Renzo Colombo; Alberto Martini; Andrea Necchi; Roberto Contieri; Rodolfo Hurle; Paolo Umari; Stefania Zamboni; Claudio Simeone; Francesco Soria; Giancarlo Marra; Paolo Gontero; Jeremy Yuen-Chun Teoh; Tobias Klatte; Anne-Sophie Bajeot; Mathieu Roumiguié; Morgan Rouprêt; Alexandra Masson-Lecomte; Ekaterina Laukhtina; Anne Sophie Valiquette; M Carmen Mir; Alessandro Antonelli; Sarah M H Einerhand; Kees Hendricksen; Roberto Carando; Christian D Fankhauser; Philipp Baumeister; Agostino Mattei; Shahrokh F Shariat; Marco Moschini Journal: World J Urol Date: 2022-02-26 Impact factor: 4.226
Authors: Mike Wenzel; Marina Deuker; Luigi Nocera; Claudia Collà Ruvolo; Zhe Tian; Shahrokh F Shariat; Fred Saad; Alberto Briganti; Andreas Becker; Luis A Kluth; Felix K H Chun; Pierre I Karakiewicz Journal: Front Oncol Date: 2021-01-29 Impact factor: 6.244
Authors: Mihaela Georgiana Musat; Christina Soeun Kwon; Elizabeth Masters; Slaven Sikirica; Debduth B Pijush; Anna Forsythe Journal: Clinicoecon Outcomes Res Date: 2022-01-10