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Radical cystectomy plus chemotherapy in patients with pure squamous cell bladder carcinoma: a population-based study
- Source :
- World Journal of Urology. 39:813-822
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Purpose: To test the effect of perioperative chemotherapy (CHT) on overall mortality (OM) and cancer-specific mortality (CSM) in patients with locally advanced or metastatic squamous cell carcinoma of the urinary bladder (SCC UB). Methods: Within the Surveillance, Epidemiology and End Results database (1988–2016), we identified 1,018 SCC UB patients (664 T3–4aN0M0, 197 TanyN1–3M0 and 156 T4bN0–3 or M1), who underwent radical cystectomy with or without perioperative chemotherapy administration. Inverse probability of treatment-weighting (IPTW), Kaplan–Meier plots and Cox-regression models (CRMs) were used. Results: CHT was administrated in 116 (17.5%) T3–4aN0M0, 77 (39.1%) TanyN1–3M0 and 47 (30.1%) T4bN0–3 or M1 patients. IPTW-adjusted 2-year cancer-specific survival (CSS) was 66.5 vs. 71.5% (p = 0.19), 60.9 vs. 29.5% (p < 0.001) and IPTW-adjusted 1-year CSS was 46.2 vs. 31.1% (p = 0.03) for CHT vs. no CHT administration in T3–4aN0M0, TanyN1–3M0 and T4bN0–3 or M1, respectively. In multivariable IPTW-adjusted CRMs, chemotherapy was an independent predictor of lower CSM in TanyN1–3M0 (HR 0.44) and in T4bN0–3 or M1 (HR 0.60), but not in T3–4aN0M0 (p = 0.6) patients. Virtually the same results were obtained on OM, as well as without IPTW-adjustment and after stratification according to age and gender. Conclusions: The use of perioperative CHT in patients with SCC UB confers survival benefit in the presence of T4b disease, lymph node or distant metastases. Conversely, patients with locally advanced disease but negative lymph node invasion do not benefit from its use. Pending higher quality data from prospective trials, these data should encourage the use of perioperative CHT in those high-risk patient groups.
- Subjects :
- Nephrology
medicine.medical_specialty
Histology
Urology
medicine.medical_treatment
030232 urology & nephrology
Cystectomy
Metastatic disease
03 medical and health sciences
0302 clinical medicine
Locally advanced disease
Internal medicine
medicine
Carcinoma
Lymph node
Chemotherapy
Urinary bladder
Bladder cancer
Systemic therapy
business.industry
Perioperative
medicine.disease
SEER database
medicine.anatomical_structure
030220 oncology & carcinogenesis
business
Subjects
Details
- ISSN :
- 14338726 and 07244983
- Volume :
- 39
- Database :
- OpenAIRE
- Journal :
- World Journal of Urology
- Accession number :
- edsair.doi.dedup.....697035bbeaa6ec2078c709400d283d8c
- Full Text :
- https://doi.org/10.1007/s00345-020-03247-3