ArticleCancer medicine2018
National Cancer Database Comparison of Radical Cystectomy vs Chemoradiotherapy for Muscle-Invasive Bladder Cancer: Implications of Using Clinical vs Pathologic Staging.
Article in Cancer medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Oncological effectiveness of bladder-preserving trimodal therapy versus radical cystectomy for the treatment of muscle-invasive bladder cancer: a system review and meta-analysis.World journal of surgical oncology · 2023Pooled it
- Comparative survival analysis of bladder preservation therapy versus radical cystectomy in muscle-invasive bladder cancer.Cancer medicine · 2024Article
- Does the introduction of pre-operative cardiopulmonary exercise testing in radical cystectomy delay or alter surgical care?BJUI compass · 2022Article
- Comparing Long-Term Survival Outcomes for Muscle-Invasive Bladder Cancer Patients Who Underwent with Radical Cystectomy and Bladder-Sparing Trimodality Therapy: A Multicentre Cohort Analysis.Journal of oncology · 2022Article
- [Locally advanced or oligometastatic bladder cancer-role of local treatment of the primary tumor and metastases].Der Urologe. Ausg. A · 2021Review
- Defining cisplatin eligibility in patients with muscle-invasive bladder cancer.Nature reviews. Urology · 2021Review
- Trimodality Therapy for Muscle-Invasive Bladder Cancer: Recent Advances and Unanswered Questions.Current oncology reports · 2020Review
- The perils of using registry data to compare the survival and cost of radical cystectomy and trimodality therapy in bladder cancer.Translational andrology and urology · 2019Article
- Trimodality therapy for bladder cancer: modern management and future directions.Current opinion in urology · 2019Review
- Clinicopathological impacts of c-Met overexpression in bladder cancer: evidence from 1,336 cases.OncoTargets and therapy · 2019Article
- National Cancer Database Comparison of Radical Cystectomy vs Chemoradiotherapy for Muscle-Invasive Bladder Cancer: Implications of Using Clinical vs Pathologic Staging.Cancer medicine · 2018Article
- Patterns of care and associated social determinants of health in the definitive treatment of localized muscle-invasive bladder cancer patients.Bladder cancer (Amsterdam, Netherlands)Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo test the hypothesis that bladder preservation therapy consisting of definitive chemoradiotherapy (chemoRT) results in similar overall survival rates to radical cystectomy/chemotherapy when balancing baseline patient characteristics and initial (preoperative) clinical stage. MATERIALS/
methodsA total of 7,322 patients with stage II-IV, M0 bladder cancer who were treated with cystectomy/chemo (N = 5,664) or definitive chemoRT (N = 1,658) were identified from the National Cancer Database. Baseline patient characteristics were compared using Pearson's chi-square, Fisher's exact test, and Wilcoxon's rank sum tests. Cox regressions were used to investigate for variables significantly correlated with overall survival (OS). OS was compared between cystectomy/chemo vs chemoRT before and after propensity score matched pair analyses using Kaplan-Meier curves and log-rank tests.
resultsPatients who underwent cystectomy/chemo were significantly younger than ones treated with definitive chemoRT (mean age 63.7 vs 75.2; P < 0.001). Age, race, Charlson/Deyo Comorbidity Score (CDCS), clinical stage, insurance status, and type of facility significantly correlated with OS (P < 0.05 for all covariates). Patients treated with cystectomy/chemo were younger, healthier with better CDCS, and more likely treated at academic facilities. Before matched pair analyses, OS was significantly better when treated with cystectomy/chemo (3 year 56.4%; 5 year 45.9%) compared to chemoRT (3 year 47.3%; 5 year 33.2%) (P < 0.001); 28.6% of patients undergoing cystectomy were upstaged at the time of surgery. After matched pair analyses matching age, race, sex, CDCS, clinical (presurgical) stage, insurance, and facility type (N = 1,750), OS was no longer significantly different between cystectomy/chemo (3 year 52.1% and 5 year 41.0%) vs chemoRT (3 year 53.3% and 5 year 40.1%) (P = 0.5).
conclusionsPatients treated with cystectomy/chemo were significantly younger and healthier compared to those treated with chemoRT. Once these factors were accounted for in propensity score matched pair analyses using clinical stage, overall survival was not significantly different between cystectomy/chemo and an organ-sparing approach with definitive chemoRT.
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