Evidence map›Paper›PMID 34337540›Full record

ArticleEuropean urology open science2021

Outcomes for Muscle-invasive Bladder Cancer with Radical Cystectomy or Trimodal Therapy in US Veterans.

Abhishek Kumar, Daniel R Cherry, Patrick T Courtney, Vinit Nalawade, Nikhil Kotha, Paul J Riviere, Jason Efstathiou, Rana R McKay, A Karim Kader, Brent S Rose and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European urology open science, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
5.4field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Review
  6. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Abhishek KumarDepartment of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA.
Daniel R CherryDepartment of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA.
Patrick T CourtneyDepartment of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA.
Vinit NalawadeDepartment of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA.
Nikhil KothaDepartment of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA.
Paul J RiviereDepartment of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA.
Jason EfstathiouDepartment of Radiation Oncology, Harvard, Cambridge, MA, USA.
Rana R McKayDivision of Hematology-Oncology, Department of Internal Medicine, University of California San Diego, La Jolla, CA, USA.
A Karim KaderDepartment of Urology, University of California San Diego, La Jolla, CA, USA.
Brent S RoseDepartment of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA.
Tyler F StewartDivision of Hematology-Oncology, Department of Internal Medicine, University of California San Diego, La Jolla, CA, USA.
University of California, San Diego · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
NCATS NIH HHS UL1 TR001863
6 · The paper itself

Abstract

backgroundMuscle-invasive bladder cancer (MIBC) remains undertreated despite multiple potentially curative options. Both radical cystectomy (RC) with or without neoadjuvant chemotherapy and trimodal therapy (TMT), including transurethral resection of bladder tumor followed by chemoradiotherapy, are standard treatments.

objectiveTo evaluate real-world clinical outcomes of RC with neoadjuvant chemotherapy (RC-NAC), RC without NAC, TMT with National Comprehensive Cancer Network guideline-preferred radiosensitizing chemotherapy including cisplatin or mitomycin-C and 5-fluorouracil (pTMT), and TMT with nonpreferred chemotherapy (npTMT). DESIGN SETTING AND

participantsUS veterans with nonmetastatic MIBC (T2-4aN0-3M0) were studied. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Overall mortality (OM) was evaluated with multivariable Cox proportional hazard model. Bladder cancer-specific mortality (BCSM) was evaluated with multivariable Fine-Gray regression. Salvage cystectomy rates were obtained by chart review. RESULTS AND LIMITATIONS: Overall 2306 patients were included: 1472 (64%) with RC without NAC, 506 (22%) with RC-NAC, 163 (7%) with pTMT, and 165 (7%) with npTMT. On multivariable analysis, pTMT was associated with similar OM (hazard ratio [HR] 1.19; 95% confidence interval [CI] 0.94-1.50;

conclusionsIn MIBC, patients receiving pTMT have comparable survival in RC-NAC patients ≥65 yr and inferior survival in RC-NAC patients <65 yr. Salvage cystectomy rates were low. PATIENT SUMMARY: Management of muscle-invasive bladder cancer is a multidisciplinary effort requiring thoughtful discussions with patients about treatment options, including trimodal therapy, which is an effective treatment option.

Indexed as

Bladder preservationChemoradiotherapyMuscle-invasive bladder cancerRadical cystectomyTreatmentTrimodal therapy

Identifiers

PMID34337540
PMCPMC8317783
OpenAlexW3170063492

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.