Evidence map›Paper›PMID 42905533›Full record

ArticleInternational journal of urology : official journal of the Japanese Urological Association2026

Changes in Treatment Patterns and Survival Outcomes Across Therapeutic Eras in Metastatic Urothelial Carcinoma: A Multicenter Real-World Study.

Sadafumi Tomioka, Satoshi Inoue, Rion Kawase, Yuriko Nagasaka, Tomoki Hattori, Noritoshi Shamoto, Fumihiro Ito, Yuri Yuguchi, Hideji Kawanishi, Motohiro Maeda and 4 more

Abstract readMulticenter Study
In one paragraph

Article in International journal of urology : official journal of the Japanese Urological Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Sadafumi TomiokaDepartment of Urology, Gifu Prefectural Tajimi Hospital, Tajimi, Japan.ORCID https://orcid.org/0009-0000-5256-4973
Satoshi InoueDepartment of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan.ORCID https://orcid.org/0000-0002-0393-5771
Rion KawaseDepartment of Urology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan.ORCID https://orcid.org/0009-0008-2649-2767
Yuriko NagasakaDepartment of Urology, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan.
Tomoki HattoriDepartment of Urology, Toyohashi Municipal Hospital, Toyohashi, Japan.
Noritoshi ShamotoDepartment of Urology, Kariya Toyota General Hospital, Kariya, Japan.ORCID https://orcid.org/0000-0002-0484-4513
Fumihiro ItoDepartment of Urology, Gifu Prefectural Tajimi Hospital, Tajimi, Japan.ORCID https://orcid.org/0009-0007-7240-6113
Yuri YuguchiDepartment of Urology, Komaki City Hospital, Komaki, Japan.
Hideji KawanishiDepartment of Urology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.ORCID https://orcid.org/0000-0002-7254-2277
Motohiro MaedaDepartment of Urology, Japan Community Health Care Organization Chukyo Hospital, Nagoya, Japan.
Kosuke TochigiDepartment of Urology, Yokkaichi Municipal Hospital, Yokkaichi, Mie, Japan.
Shusuke AkamatsuDepartment of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan.ORCID https://orcid.org/0000-0002-1394-7506
Kenji ZennamiDepartment of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
MEGUMI (MEidai GenitoUrinaryMega Investigation) project

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate temporal changes in treatment patterns and survival outcomes across therapeutic eras in patients with metastatic urothelial carcinoma.

methodsThis retrospective multicenter real-world cohort study included 727 patients with metastatic urothelial carcinoma who received first-line systemic therapy between July 2003 and September 2024. Patients were categorized into three treatment eras according to the initiation date of first-line systemic therapy: the chemotherapy era (Chemo era), pembrolizumab era (Pembro era), and avelumab era (Ave era). Overall survival was analyzed using the Kaplan-Meier method and compared using the log-rank test. Cox proportional hazards regression analyses identified independent prognostic factors.

resultsMedian overall survival was 12.7, 19.7, and 21.8 months in the Chemo, Pembro, and Ave eras, respectively. Overall survival was significantly shorter in the Chemo era than in the other eras, whereas no significant difference was observed between the Pembro and Ave eras. In multivariable analysis, poor performance status, hypoalbuminemia, elevated neutrophil-to-lymphocyte ratio, elevated C-reactive protein level, and liver, lung, and bone metastasis were independently associated with poorer overall survival. The Pembro and Ave eras were independently associated with prolonged overall survival compared with the Chemo era. Treatment patterns changed over time, with decreasing use of chemotherapy alone and increasing use of pembrolizumab-, avelumab-, and enfortumab vedotin-containing treatment sequences.

conclusionsIn this real-world cohort, survival outcomes improved across successive therapeutic eras in patients with metastatic urothelial carcinoma. Treatment patterns evolved with the introduction of novel systemic therapies, providing contemporary real-world evidence of changing treatment practices and outcomes.

Indexed as

Antibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalCarcinoma, Transitional CellUrinary Bladder NeoplasmsAgedAged, 80 and overFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesTreatment OutcomeAntibodies, Monoclonal, HumanizedAntineoplastic Agents, Immunologicalavelumabpembrolizumabenfortumab vedotinimmune checkpoint inhibitormetastatic urothelial carcinomareal‐world datatreatment patterns

Identifiers

PMID42905533
PMCPMC13686272

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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.